Breech presentation and choice of mode of childbirth: a qualitative study of women's experiences.

OBJECTIVE

To explore women's perceptions of their experience of the diagnosis of breech presentation and decision-making processes regarding the choice of mode of childbirth.

DESIGN

A qualitative study was conducted using semi-structured interviews. Data were analysed thematically.

SETTING

Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland.

PARTICIPANTS

seven primiparous and five multiparous women experiencing a singleton breech presentation for childbirth were interviewed.

FINDINGS: Two concomitant and interdependent processes were identified. First, an emotional response ranging from the hope that the fetus would return to a normal vertex position to the acceptance of breech presentation and its consequences. Second, a decision-making process related to childbirth mode for breech presentation with the complex management of intra- and extra-personal factor influences. Women perceive information about the risks of vaginal childbirth of paramount importance compared with those associated with caesarean childbirth. When women choose vaginal childbirth, influences related to their personality and life history appear to predominate. Women often have the feeling of being alone to assume the choice of childbirth mode and possible complications.

KEY

CONCLUSIONS

The diagnosis of breech presentation should not be treated as a commonplace event. The role of caregivers needs to go beyond information on the risks and benefits of both modes of childbirth. Emphasis should be placed on listening to the expectations of pregnant women for childbirth, creating spaces for dialogue, and allowing additional time for reflection. Useful information material should be provided to give the women a feeling of shared decision-making.