Important factors working to mediate Swedish fathers' experiences of a caesarean section

To describe and explore fathers' experiences of their partner's caesarean section birth.

A qualitative descriptive design was employed. A self-selected sample of 22 Swedish fathers who had experienced an elective or emergency caesarean section agreed to participate. Men were interviewed by telephone seven to 16 months after the birth of their baby. Thematic analysis and the techniques of constant comparison were used to analyse the data.

Men were generally worried about the health and well-being of their baby and partner regardless of birth mode. As the reality of the caesarean section approached men's anxiety escalated and remained high during the procedure. The rapid nature of surgical birth was therefore considered as an advantage; once the baby was born and cried men's fear dissipated. Four factors were identified that mediated the men's experience. Men's perceptions of control, preparedness and how the health-care team behaved and interacted with them were integral to their experience. Knowing the date and time of birth also mediated the experience by providing a sense of certainty to men's experiences of the caesarean birth.

Caesarean section was considered as a routine and safe procedure that offered most fathers a sense of certainty, control and safety lessening their sense of responsibility over ensuring a healthy baby. The communication patterns of staff played a key role in ensuring a positive caesarean birth experience.

Ensuring that men have a positive birth experience, regardless of birth mode, is important for family functioning. However the findings also lend insight into how men may reframe caesarean birth as normal and safe. This may have implications for decision making around birth mode in a subsequent pregnancy further impacting on rising repeat caesarean section rates. Health-care professionals need to provide balanced information about the risks associated with caesarean birth. Any potential benefits need to be contextualised to the pregnant woman's own individual situation. Where possible, and appropriate, professional discourses should support vaginal birth as the safest option for a woman and her baby.