Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

The association of patient preferences and attitudes with trial of labor after cesarean

Journal of Perinatology volume 39, pages 1340–1348 (2019)Cite this article

Subjects

A Correction to this article was published on 10 October 2019

This article has been updated

Abstract

Objective

To evaluate the association of patient preferences and attitudes with TOLAC.

Study design

Prospective observational study of TOLAC-eligible women at 26–34 weeks gestation. Preferences (utilities) were elicited using the time trade-off and standard gamble metrics. Logistic regression was used to identify preference- and attitude-based factors associated with TOLAC.

Results

Of the 231 participants, most (n = 197, 85%) preferred vaginal delivery, but only 40% (n = 93) underwent TOLAC. Utilities for uterine rupture outcomes did not differ based on delivery approach. In multivariable analysis, strength of preference for vaginal delivery, value for the experience of labor, and the opinion of the person whom the participant thought of as most important to this decision were associated with TOLAC.

Conclusions

Future decision support interventions incorporating individualized information regarding the likelihood of vaginal birth and empowering patients to express their preferences and engage their families in the decision-making process may improve decision quality and increase TOLAC rates.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

Change history

  • 10 October 2019

    An amendment to this paper has been published and can be accessed via a link at the top of the paper.

References

  1. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Matthews TJ. Births: Final data for 2015. National vital statistics report; vol 66, no 1. Hyattsville, MD: National Center for Health Statistics; 2017.

  2. National Vital Statistics Reports. Births: Final Data for 2017. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/DVS/natality/UserGuide2015.pdf accessed 4/30/17.

  3. Guise J-M, Eden K, Emeis C, Denman MA, Marshall N, Fu R, et al. Vaginal birth after cesarean: new insights. Evidence report/Technology assessment no.191. (prepared by the Oregon Health & Science University Evidence-based Practice Center under contract no. 290-2007-10057-I). AHRQ publication no. 10-E003. Rockville, MD: Agency for Healthcare Research and Quality; 2010.

  4. Grobman WA, Lai Y, Landon MB, Spong CY, Rouse DJ, Varner MW, et al. The change in the rate of vaginal birth after caesarean section. Paediatr Perinat Epidemiol. 2011;25:37–43.

    Article  PubMed  Google Scholar 

  5. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol. 2010;116(2 Pt 1):450–63.

    Google Scholar 

  6. Wu J, Fulton R, Amundsen C, Knight S, Kuppermann M. Patient preferences for different severities of and treatments for overactive bladder. Female Pelvic Med Reconstr Surg. 2011;17:184–9.

    Article  PubMed  Google Scholar 

  7. Yee LM, Kaimal AJ, Houston KA, Wu E, Thiet MP, Nakagawa S, et al. Mode of delivery preferences in a diverse population of pregnant women. Am J Obstet Gynecol. 2015;212:377.e1–24.

    Article  Google Scholar 

  8. Wu E, Kaimal AJ, Houston K, Yee LM, Nakagawa S, Kuppermann M. Strength of preference for vaginal birth as a predictor of delivery mode among women who attempt a vaginal delivery. Am J Obstet Gynecol. 2014;210:440.e1–6.

    Article  Google Scholar 

  9. Rutter D, Quine L. Social cognition models and changing health behaviours. In: Rutter D, Quine L, editors. Changing health behaviour intervention and research with social cognition models. Buckingham: Open University Press; 2002.

  10. Ajzen I. Attitudes, personality and behavior. Milton Keynes: Open University Press; 1988.

  11. Grobman WA, Lai Y, Landon MB, Spong CY, Leveno KJ, Rouse DJ, et al. National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU), “Development of a nomogram for prediction of vaginal birth after cesarean delivery,” Obstet and Gynecol. 2007;109: 806–12.

  12. Vittinghoff E, McCulloch CE. Relaxing the rule of ten events per variable in logistic and cox regression. Am J Epidemiol. 2007;165:710–8.

    Article  PubMed  Google Scholar 

  13. Kaimal AJ, Kuppermann M. Understanding risk, patient and provider preferences, and obstetric decision making: approach to delivery after cesarean. Semin Perinatol. 2010 34:331–6.

    Article  PubMed  Google Scholar 

  14. McMahon MJ, Luther ER, Bowes WA Jr, Olshan AF. Comparison of a trial of labor with an elective second cesarean section. N Engl J Med. 1996;335:689–95.

    Article  CAS  PubMed  Google Scholar 

  15. Grobman WA, Lai Y, Landon MB, Spong CY, Leveno KJ, Rouse DJ, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Can a prediction model for vaginal birth after cesarean also predict the probability of morbidity related to a trial of labor? Am J Obstet Gynecol. 2009;200:56.e1–6.

    Article  Google Scholar 

  16. Chaillet N, Bujold E, Dubé E, Grobman WA. Validation of a prediction model for predicting the probability of morbidity related to a trial of labour in Quebec. J Obstet Gynaecol Can. 2012;34:820–5.

    Article  PubMed  Google Scholar 

  17. Stewart BM, Weston W, McWHinney I, et al. Patient-centered medicine: transforming the clinical method. London: Sage Publications; 1995.

  18. Legare F, O’Connor AC, Graham I, Saucier D, Cote L, Cauchon M, et al. Supporting patients facing difficult health care decisions: use of the Ottawa Decision Support Framework. Can Fam Physician. 2006;52:476–7.

    PubMed  PubMed Central  Google Scholar 

Download references

Funding

This work was supported by NIH/NICHD R01 HD078748 (PI Kuppermann).

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA

    Anjali J. Kaimal & Allison Bryant

  2. Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    William A. Grobman

  3. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA

    Cinthia Blat, Juan Gonzalez & Mari-Paule Thiet

  4. Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA

    Peter Bacchetti

  5. Marin Community Clinic, San Rafael, CA, USA

    Yamilee Bermingham

  6. Departments of Obstetrics, Gynecology & Reproductive Sciences and Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA

    Miriam Kuppermann

Authors
  1. Anjali J. Kaimal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. William A. Grobman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Allison Bryant
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cinthia Blat
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peter Bacchetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Juan Gonzalez
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mari-Paule Thiet
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yamilee Bermingham
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Miriam Kuppermann
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors certify that they made substantial contributions to the conception or design of the work (AK, WG, AB, PB, and MK); or the acquisition, analysis, or interpretation of data for the work (AK, WG, AB, PB, MK, CB, JG, MPT, and YB); and Drafted the work or revising it critically for important intellectual content (AK, WG, AB, PB, MK, CB, JG, MPT, and YB); and Gave final approval of the version to be published (AK, WG, AM, PB, MK, CB, JG, MPT, and YB); and Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. (AK, WG, AM, PB, MK, CB, JG, MPT, and YB).

Corresponding author

Correspondence to Anjali J. Kaimal.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kaimal, A.J., Grobman, W.A., Bryant, A. et al. The association of patient preferences and attitudes with trial of labor after cesarean. J Perinatol 39, 1340–1348 (2019). https://doi.org/10.1038/s41372-019-0399-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-019-0399-5

This article is cited by

Search

Advanced search

Quick links