Background A proportion of women requesting Caesarean section (CS) do so due to a previous traumatic birth experience with the expectation that a CS will improve their next birth experience. Obstetricians involved the care of these women have little evidence as to whether a CS does in fact improve women's satisfaction and it is a controversial indication. This qualitative study provides information about why these women request CS, whether they are satisfied and thus may help inform obstetric management.

Methods Nine women who requested CS following a traumatic birth and 10 obstetricians were interviewed. The women were asked about their previous birth experience, their satisfaction with CS, and what factors could have influenced their decision. Obstetricians were asked about maternal request for CS following traumatic birth and their management of these women.

Analysis Framework approach, key themes identified.

Results Key themes

Women: reasons why their birth was traumatic (loss of control, pain, poor communication); suggestions as to how the birth experience could be improved, (debriefing consistently suggested); overall women were satisfied with their decision.

Obstetricians: previous traumatic birth perceived as a valid indication for CS, sub themes were what was considered traumatic and whether it improved satisfaction; conviction that if the initial birth experience was improved this would reduce such CS requests (debriefing consistently suggested).

Conclusion Women were satisfied with planned CS following a previous traumatic birth but both groups interviewed were keen to prevent the initial traumatic birth with debriefing being a consistent key theme.