Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




The purpose of this study is to generate a theory of the decision making process for women as they choose a birth option after a previous Cesarean delivery. The research method of choice when little is known about the phenomena is qualitative research. A qualitative approach was used to generate a substantive theory of decision making for women deciding subsequent pregnancy birth mode after a previous Cesarean delivery. The classical grounded theory methodology including sampling plan, recruitment, data collection and analysis outlined in Glaser and Strauss (1967) guided this study. Twelve study participants with a history of one previous Cesarean delivery were recruited for this study over a 9-month period. Each interview was audio recorded and transcribed verbatim. Consistent with the grounded theory method, the first interview was coded before proceeding to the second interview (Glaser & Strauss, 1967). Then, data from the second interview was constantly compared to the first interview codes and this process was repeated until all data were collected for the study.The theory consists of a core category and seven conceptual categories. Based on the data, the decision making process of subsequent pregnancy birth mode of VBAC or RCS after a primary Cesarean birth begins with having a Cesarean delivery for the first birth. This is followed by the women's judgments of the first Cesarean delivery experience. From the experience of the first Cesarean, women seek information about subsequent birth modes, which leads them to know more about subsequent birth modes and aids in getting to a decision of wanting a VBAC or wanting a RCS for subsequent birth. In this process, depending on desired birth mode, women search for a supporting provider. The core category is central to other categories, recurrent in the data, and accounts for a majority of the variation in the pattern of behavior (Glaser, 1978). Wanting a different birthing experience emerged as the core category from the data. It was persistent in the data and central to all seven categories.The theory provides unique implications to nursing research, education, administration and practice. The generated theory in this study will provide a research based theory for healthcare professionals to use to guide them in counseling women as they make the decision of subsequent pregnancy birth mode after a previous Cesarean delivery.

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Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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