Method: Participants (N = 448 women) whose first birth was a cesarean birth and were intending to have a second child, pregnant with a second child, or had already had a second child qualified to take the survey. Questions included birth plans, the outcomes and feelings of past pregnancies, risk perception of VBAC versus ERCD, influences of birth plans, and birth stories they have heard. The Multidimensional Health Locus of Control Scales for Labor and Delivery (Stevens, Hamilton, & Wallston, 2011) was also administered. We followed up with 48 women who were pregnant during the first survey to examine shifts in locus of control.
Result: Women who choose to TOLAC believe a cesarean is riskier than a VBAC, are less satisfied with their first birth experience, have a higher internal locus of control, and are more likely to list doulas, online information, support groups, and educational experience as influential. We found no significant effects for the women who were retested after their second birth, but those who decide to VBAC heard more pro-VBAC stories and sought more information. ERCD women believe attempting a VBAC is riskier than a scheduled cesarean, score higher on “powerful others” locus of control, and identified family (beyond partner), and health providers as influential.
Conclusion: TOLAC women are less likely to believe a health provider will direct a successful outcome and more likely to believe that they have control over the outcome of their birth. Doulas, online information, support groups, and educational experience were more likely to be identified as influential sources for TOLAC women than for ERCD women. Health providers were 2-3 times more likely to be listed as the primary influence on birth plan for ERCD women than TOLAC women.