Interpregnancy interval planning after caesarean section: a feminist thematic analysis of women’s understanding and decision making when planning another pregnancy

Problem: There is limited research on women’s perception of risk regarding pregnancy after caesarean. Background: Interpregnancy interval alters risk in the next pregnancy and birth following a caesarean. Interpregnancy interval is a potentially modifiable risk that health care providers need to consider when counselling women about future pregnancy plans. Question: What is women’s experience of decision making regarding interpregnancy interval after caesarean birth? Methods: Twelve women participated in in-depth interviews; these were analysed thematically assisted by the use of NViVO software. Findings: The overarching theme identified was “Finding my way through the confusion to make informed decisions”. Women are receiving confusing biased information delivered at varying time points. This is not meeting women’s information needs leading them to seek knowledge through other sources, including online peers, to make sense of the confusion. They gather their own knowledge in order to advocate for themselves, make pregnancy spacing decisions that fit with their expectations and maximise the chances of having the birth they want. Discussion: Consistent evidence based information is lacking in the current maternity care environment regarding interpregnancy interval. This creates barriers to making informed decisions for next pregnancy and birth planning. Women are looking for evidence based information to make individualised decisions. This requires women to seek knowledge outside of the maternity care system to empower themselves to navigate the system and make decisions rather than following prescriptive directives. Conclusion: There is a need to provide evidence based pregnancy planning resources to women that facilitate informed shared decision making.