Table 4 Associations between perceived challenges regarding promoting/performing TOLAC and intention to recommend TOLAC to pregnant women with a history of CS among Chinese obstetricians (N = 426)
Total mean ± SD/f (%) | Intended (n = 294) mean (SD)/f (%) | Not intended (n = 132) mean (SD)/f (%) | t/χ2 | P | |
|---|---|---|---|---|---|
Lack of clear guidelines for predicting or avoiding the risks associated with TOLAC, such as uterine rupture | 0.05 | 0.89 | |||
Yes | 359 (84.3) | 247 (84.0) | 112 (84.8) | ||
No | 67 (15.7) | 47 (16.0) | 20 (15.2) | ||
Obstetricians’ uncertainty about the safety of TOLAC for pregnant women with a history of CS | 6.90 | 0.01* | |||
Yes | 346 (81.2) | 229 (77.9) | 117 (88.6) | ||
No | 80 (18.8) | 65 (22.1) | 15 (11.4) | ||
Perceived unwillingness to accept the risks associated with TOLAC among pregnant women with a history of CS | 1.20 | 0.29 | |||
Yes | 345 (81.0) | 234 (79.6) | 111 (84.1) | ||
No | 81 (19.0) | 60 (20.4) | 21 (15.9) | ||
Perceived lack of confidence regarding undergoing TOLAC among pregnant women with a history of CS and their family members | 11.05 | 0.01** | |||
Yes | 330 (77.5) | 241 (82.0) | 89 (67.4) | ||
No | 96 (22.5) | 53 (18.0) | 43 (32.6) | ||
Perceived insufficient understanding or even misunderstanding regarding TOLAC among pregnant women with a history of CS and their family members | 0.48 | 0.50 | |||
Yes | 297 (69.7) | 208 (70.7) | 89 (67.4) | ||
No | 129 (30.3) | 86 (29.3) | 43 (32.6) | ||
Worries about medical lawsuits due to adverse delivery outcomes after recommending TOLAC to pregnant women with a history of CS | 8.31 | 0.01** | |||
Yes | 294 (69.0) | 194 (66.0) | 100 (34.0) | ||
No | 132 (31.0) | 124 (93.9) | 8 (6.1) | ||
Lack of clear acceptable medical standards or definitive guidelines for TOLAC in local clinical practice | 1.00 | 0.32 | |||
Yes | 238 (55.9) | 169 (57.5) | 69 (52.3) | ||
No | 188 (44.1) | 125 (42.5) | 63 (47.7) | ||
Lack of facilities to carry out TOLAC | 3.54 | 0.07 | |||
Yes | 197 (46.2) | 127 (43.2) | 70 (53.0) | ||
No | 229 (53.8) | 167 (56.8) | 62 (47.0) | ||
Clinical experience and skill level of obstetrician are insufficient | 0.00 | 1.00 | |||
Yes | 187 (43.9) | 129 (43.9) | 58 (43.9) | ||
No | 239 (56.1) | 165 (56.1) | 74 (56.1) | ||
Substandard gestation management of pregnant women with a history of CS | 0.26 | 0.67 | |||
Yes | 182 (42.7) | 128 (43.5) | 54 (40.9) | ||
No | 244 (57.3) | 166 (56.5) | 78 (59.1) | ||
Clinical experience and skill level of midwife are insufficient | 0.94 | 0.39 | |||
Yes | 163 (38.3) | 108 (36.7) | 55 (41.7) | ||
No | 263 (61.7) | 186 (63.3) | 77 (81.5) |