Demographic, Socioeconomic, Health Systems, and Geographic Factors Associated with Vaginal Birth After Cesarean: An Analysis of 2017 U.S. Birth Certificate Data

Ibrahim, Bridget Basile; Kennedy, Holly Powell; Holland, Margaret L.

doi:10.1007/s10995-020-03066-3

Cited by 10 publications

(12 citation statements)

References 44 publications

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“…In our sample, and in national data, individuals with higher levels of education were more likely to have a VBAC. The 72% VBAC completion rate in our sample is congruent with the 73% national rate for 2017 54 . Participants living in the South had the lowest rates of VBAC, as did the Southern Census region in the 2017 birth certificate data 54 .…”

Section: Discussionsupporting

confidence: 73%

“…The demographic findings of this study mirror trends in VBAC from the 2017 national birth certificate data 53,54 and the Access and Integration Maternity Care Mapping study 55 . In our sample, and in national data, individuals with higher levels of education were more likely to have a VBAC.…”

Section: Discussionsupporting

confidence: 67%

“…The 72% VBAC completion rate in our sample is congruent with the 73% national rate for 2017 54 . Participants living in the South had the lowest rates of VBAC, as did the Southern Census region in the 2017 birth certificate data 54 . Future research should explore whether lower rates of VBAC in the South are related to regulatory restrictions, geographic or racial inequities in access to supportive providers, and/or lower rates of hospitals offering care for individuals desiring a VBAC.…”

Section: Discussionsupporting

confidence: 64%

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“I had to fight for my VBAC”: A mixed methods exploration of women’s experiences of pregnancy and vaginal birth after cesarean in the United States

Ibrahim

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Vedam

et al. 2020

Birth

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Background Vaginal birth after cesarean (VBAC) is safe, cost‐effective, and beneficial. Despite professional recommendations supporting VBAC and high success rates, VBAC rates in the United States (US) have remained below 15% since 2002. Very little has been written about access to VBAC in the United States from the perspectives of birthing people. We describe findings from a mixed methods study examining experiences seeking a VBAC in the United States. Methods Individuals with a history of cesarean and recent subsequent birth were recruited through social media groups. Using an online questionnaire, we collected sociodemographic and birth history information, qualitative accounts of participants’ experiences, and scores on the Mothers on Respect Index, the Mothers Autonomy in Decision Making Scale, and the Generalized Self‐Efficacy Scale. Results Participants (N = 1711) representing all 50 states completed the questionnaire; 1151 provided qualitative data. Participants who planned a VBAC reported significantly greater decision‐making autonomy and respectful treatment in their maternity care compared with those who did not. The qualitative theme: “I had to fight for my VBAC” describes participants’ accounts of navigating obstacles to VBAC, including finding a supportive provider and traveling long distances to locate a clinician and/or hospital willing to provide care. Participants cited support from providers, doulas, and peers as critical to their ability to acquire the requisite knowledge and power to effectively self‐advocate. Discussion Findings highlight the difficulties individuals face accessing VBAC within the context of a complex health system and help to explain why rates of attempted VBAC remain low.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 67%

Section: Discussionsupporting

confidence: 64%

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“I had to fight for my VBAC”: A mixed methods exploration of women’s experiences of pregnancy and vaginal birth after cesarean in the United States

Ibrahim

Shorten

Vedam

et al. 2020

Birth

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“…In our sample, 29% of participants were attended by midwives and 10% gave birth at home. This increased use of midwifery care may explain the higher rate of vaginal birth in our sample (73%) compared with the US rate of 68% 36 . The United States is an outlier among high income countries for the high rate of cesarean birth, high rate of maternal morbidity and mortality, and low midwife to physician ratio 37 .…”

Section: Discussionmentioning

confidence: 58%

“…Midwifery care is associated with higher rate of vaginal birth, 35 and among our sample, having a vaginal birth and having a midwife provider were each significantly associated with experiencing high‐quality perinatal care. Nationally, 10% of all births are attended by midwives and slightly over 98% of women give birth in a hospital 36 . In our sample, 29% of participants were attended by midwives and 10% gave birth at home.…”

Section: Discussionmentioning

confidence: 71%

Experiences of Quality Perinatal Care During the US COVID‐19 Pandemic

Ibrahim

Kennedy

Combellick

2021

J Midwife Womens Health

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Introduction Quality perinatal care is recognized as an important birth process and outcome. During the coronavirus disease 2019 (COVID‐19) pandemic, quality of perinatal care was compromised as the health care system grappled with adapting to an ever‐changing, uncertain, and unprecedented public health crisis. Methods The aim of this study was to explore the quality of perinatal care received during the COVID‐19 pandemic in the United States. Data were collected via an online questionnaire completed by people who gave birth in the United States after March 15, 2020. The questionnaire included the Mothers on Respect Index and the Mothers Autonomy in Decision Making validated measures. Low‐quality perinatal care was defined as decreased respect and/or autonomy in the perinatal care received. Responses were geocoded by zip code to determine COVID‐19 case‐load in the county on the date of birth. Multivariate regression analyses described associations between respect and autonomy in decision‐making for perinatal care and levels of COVID‐19 outbreak across the United States. Results Participants (N = 707) from 46 states and the District of Columbia completed the questionnaire. As COVID‐19 cases increased, participants’ experiences of autonomy in decision‐making for perinatal care decreased significantly (P = .04). Participants who identified as Black, Indigenous, and people of color, those who had an obstetrician provider, and those who gave birth in a hospital were more likely to experience low‐quality perinatal care. Those with a midwife provider or who had a home birth were more likely to experience high‐quality perinatal care in adjusted models. Discussion Variability in experiences of high‐quality perinatal care by sociodemographic characteristics, birth setting, and provider type may relate to implicit bias, structural racism, and inequities in maternal health and COVID‐19 outcomes for birthing people from marginalized communities.

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What to Expect When You’re Delivering? How the Gender Structure is Reinforced Through Fictional Depictions of Childbirth

Chiareli,

Beutel

2024

Gend. Issues

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Demographic, Socioeconomic, Health Systems, and Geographic Factors Associated with Vaginal Birth After Cesarean: An Analysis of 2017 U.S. Birth Certificate Data

Cited by 10 publications

References 44 publications

“I had to fight for my VBAC”: A mixed methods exploration of women’s experiences of pregnancy and vaginal birth after cesarean in the United States

“I had to fight for my VBAC”: A mixed methods exploration of women’s experiences of pregnancy and vaginal birth after cesarean in the United States

Experiences of Quality Perinatal Care During the US COVID‐19 Pandemic

What to Expect When You’re Delivering? How the Gender Structure is Reinforced Through Fictional Depictions of Childbirth

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