Women's reasons for, and experiences of, choosing a homebirth following a caesarean section

Caesarean section is rising in the developed world and vaginal birth after caesarean (VBAC) is declining. There are increased reports of women seeking a homebirth following a caesarean section (HBAC) in Australia but little is known about the reasons for this study aimed to explore women's reasons for and experiences of choosing a HBAC.

Twelve women participated in a semi-structured one-to-one interview. The interviews were digitally recorded, then transcribed verbatim. These data were analysed using thematic analysis.

The overarching theme that emerged was 'It's never happening again'. Women clearly articulated why it [caesarean section] was never happening again under the following sub themes: 'treated like a piece of meat', 'I was traumatised by it for years', 'you can smell the fear in the room', 're-traumatised by the system'. They also described how it [caesarean section] was never happening again under the sub themes: 'getting informed and gaining confidence', 'avoiding judgment through selective telling', 'preparing for birth', 'gathering support' and 'all about safety but I came first'. The women then identified the impact of their HBAC under the subthemes 'I felt like superwoman' and 'there is just no comparison'.

Birth intervention may cause physical and emotional trauma that can have a significant impact on some women. Inflexible hospital systems and inflexible attitudes around policy and care led some women to seek other options. Women report that achieving a HBAC has benefits for the relationship with their baby. VBAC policies and practices in hospitals need to be flexible to enable women to negotiate the care that they wish to have.