Doctoral Dissertations

Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

Joanne Hall

Committee Members

Janet Witucki-Brown, Susan Speraw, June D. Gorski


The purpose of this study was to discover a theory on how women decide to deliver their babies by cesarean section instead of experiencing a trial of labor and expected vaginal delivery when it is appropriate. The specific goals are to answer the research questions: What is the decision-making process by which healthy, low-risk women choose to deliver their babies by cesarean delivery in the absence of medical indications? What antecedents occur to influence a pregant woman's decision to undergo a maternal request cesaren section? Seven women from the surrounding Knoxville area underwent in-depth interviews. To qualify for the study, the women had to be healthy and low-risk, had an elective cesarean section within the last two years, be 18 years or older and reside in the East Tennessee area. Symbolic interactionism and feminism were utilized to provide a theoretical framework for the study. The grounded theory methodology by Strauss and Corbin (1990) was used to develop the core category, context, antecedents, intervening factors and consequences. From the data, a substantive theory was identified, "Having an elective c-section: Doing what's best." The antecedents of the women's decision were being scared and perceiving a cesarean section as an easier way to give birth. Women made this choice after gathering information and seeking support from health care providers, friends and family within the context of progressing through the pregnancy. Once the decision was made and the cesarean section was performed, the women voiced happiness with their decision and in having a good outcome. The findings of this study may assist office nurses, public health nurses, midwives, advanced practice nurses, childbirth educators and other women's health nurses to educate women on their childbirth options and hopefully to reduce the rate of maternal request cesarean deliveries.

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