Interpregnancy interval planning after caesarean section: a national survey

Aim: Explore women's experience and decision making around interpregnancy interval after caesarean section. Methods: A sequential mixed methods approach was used to identify themes from qualitative interviews conducted across Australia. Data from the qualitative interviews informed a survey that was distributed nationally, via social media, over two months. In this time 332 women consented to participate in the survey. Descriptive statistics for closed questions and content analysis for open ended questions was used for analysis. Findings: Over half (58.8 %) of women reported an interpregnancy interval of 18 months or more and perception of risk for next pregnancy after caesarean birth was not recognised by 50.6 % of women. The definition of interpregnancy interval, from birth of the previous infant to conception of the next pregnancy, was confused with interbirth interval (29.9 %) or unknown (25.3 %) by most women. More than half of women reported trauma affected planning another pregnancy (54.4 %), psychological or physical. Most women (78.5 %) sought information independently from online resources including websites (51 %), social media (46.7 %) and peer groups (42.9 %). The greatest value was placed on online peer support (40.6 %), whilst evidence based information (77.9 %) had the greatest influence on pregnancy planning. Discussion: Women are seeking information outside of maternity services suggesting they are not receiving the information they need from their maternity care providers. Maternity services could learn the lessons of online groups in supporting women with evidence based accessible information. Conclusion: Interpregnancy interval continues to be poorly understood potentially impacting on choices women make in their next pregnancy. Given the value placed on online support for women who have had a caesarean birth maternity service providers should address this by providing appropriate resources. This is particularly relevant as this group of women report high rates of trauma.