Why women choose trial of labor or repeat cesarean section.

Despite growing interest in vaginal birth after previous delivery by cesarean section, virtually no studies have examined patient decision making in any depth. This paper examines the social content and cognitive structure of pregnant women's decisions to attempt delivery by trial of labor or for elective repeat cesarean section. Three features of childbirth care strategies are discussed. First, social goals are as central to women's decisions as are medical risks. Second, women reinforce their decisions by defining multiple benefits for the preferred alternative and multiple hazards for the rejected alternative. Third, women do not attempt to assess the probabilities of particular outcomes, but instead construct mental images of anticipated events based upon past childbirth experience and expected consequences of the preferred course of action.