Perceptions and practices of vaginal birth after Caesarean section among privately practicing obstetricians in Kenya

East African Medical Journal
R Koigi-KamauJ N Kiarie

Abstract

To determine perceptions, preferences and practices of vaginal birth after Caesarean. Cross-sectional descriptive study. Private clinics of obstetricians in five major towns of Kenya. Obstetricians in private practice. Practice and experiences in trial of labour (TOL); need for, and application of, selection criteria in TOL; perceptions on outcomes of TOL and patient preference; perception on trends of vaginal birth after Caesarean (VBAC) and need for policy on TOL. Nearly all respondents (98.4%) believed in the need for, and application of, selection criteria for allowing TOL. However, only 23% believed in routine screening with radiological pelvimetry, while 63.2% believed in routine foetal weight estimation. All obstetricians (100%) have ever managed TOL in private practice, and 74% had managed at least one case in the last six months. Despite lack of tangible selection criteria, 83.1% think that most women prefer TOL while 95.1% discourage it if perceived as inappropriate. Failure rate of TOL was perceived to be more than 50% by 35.2% of the respondents. A majority of the respondents (about 75%) would prefer TOL on themselves or their spouses. Those who perceived that there was a falling trend of VBAC were 58%, citing incre...Continue Reading

Citations

Nov 16, 2011·Bulletin of the World Health Organization·Sepideh Bagheri NejadDidier Pittet

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