Internet information on birth options after caesarean compared to the RCOG patient information leaflet; A web survey

Abstract

Background: Repeat caesarean sections make a substantial contribution to the overall caesarean section rate. It isimportant to understand what influences women to choose this option when the alternative of attempting vaginalbirth after caesarean section is available. As many such women use the internet while seeking information on theiroptions, the aim of this study was to assess content of websites on birth after previous caesarean and identifywebsite characteristics which predict content.Methods: An internet survey of the forty eight most frequently encountered websites retrieved from a search usingvarious terms relating to birth after caesarean section via a popular search engine was performed. Websites wereassessed for their content supportive of either vaginal birth after caesarean (VBAC) or elective repeat caesareansection (ERCS), using the RCOG patient information document, 'Birth after previous caesarean; Information for You'as a 'gold standard'. A simple scoring method which categorised information into either supportive of VBAC (14facts available) or ERCS (10 facts available) was employed and mean scores compared. Poisson regression analysiswas used to assess the extent to which the score was predicted by website funding source, country of origin,author status and intended audience.Results: A mean of 42.4% (SD 23.8) of facts supportive of VBAC and 44.8% (SD 25.0) of facts supportive of ERCSwere featured across the 48 websites, with corresponding scores in the five most frequently encountered websitesbeing 40.0% (SD 13.9) and 66.0% (SD 20.7). Extent of featured information supportive of ERCS was related tocountry of origin with the UK having higher scores on average than the US.Conclusions: Women searching for internet information on birth after previous caesarean are exposed toincomplete information. Origin of website has a significant effect on website content.