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

Whitelaw N, Bhattacharya S, McLernon D, Black M - BMC Pregnancy Childbirth (2014)

Bottom Line: A simple scoring method which categorised information into either supportive of VBAC (14 facts available) or ERCS (10 facts available) was employed and mean scores compared.Women searching for internet information on birth after previous caesarean are exposed to incomplete information.Origin of website has a significant effect on website content.

View Article: PubMed Central - PubMed

Affiliation: Division of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen AB25 2ZD, UK. mairead.black@abdn.ac.uk.

ABSTRACT

Background: Repeat caesarean sections make a substantial contribution to the overall caesarean section rate. It is important to understand what influences women to choose this option when the alternative of attempting vaginal birth after caesarean section is available. As many such women use the internet while seeking information on their options, the aim of this study was to assess content of websites on birth after previous caesarean and identify website characteristics which predict content.

Methods: An internet survey of the forty eight most frequently encountered websites retrieved from a search using various terms relating to birth after caesarean section via a popular search engine was performed. Websites were assessed for their content supportive of either vaginal birth after caesarean (VBAC) or elective repeat caesarean section (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 (14 facts available) or ERCS (10 facts available) was employed and mean scores compared. Poisson regression analysis was 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 ERCS were featured across the 48 websites, with corresponding scores in the five most frequently encountered websites being 40.0% (SD 13.9) and 66.0% (SD 20.7). Extent of featured information supportive of ERCS was related to country 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 to incomplete information. Origin of website has a significant effect on website content.

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Related in: MedlinePlus

Website content as a percentage of potential pieces of information in support of each mode of delivery after caesarean birth compared with RCOG patient information document ‘Birth after previous caesarean: Information for you’.
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Fig3: Website content as a percentage of potential pieces of information in support of each mode of delivery after caesarean birth compared with RCOG patient information document ‘Birth after previous caesarean: Information for you’.

Mentions: The number of websites demonstrating individual criteria supporting either VBAC or ERCS as outlined in the RCOG patient document was recorded (Table 2). The percentage score achieved in support of either VBAC or ERCS for each website was calculated (Figure 3). Only one of 48 websites mentioned 100% of points in favour of VBAC as mentioned in RCOG ‘gold standard’ patient information, with just two of 48 websites mentioning 100% of points in favour of ERCS. The most commonly addressed criterion was the increased risk of uterine scar rupture with VBAC (n = 45). Forty sites provided additional information in support of VBAC which not mentioned in the RCOG guidance. Most commonly cited examples included risks of wound infection (n = 21), haemorrhage (n = 18) and maternal surgical injury (n = 14) with ERCS. Twenty seven sites provided additional information in support of ERCS. Most commonly cited examples included the risk of incontinence (n = 7) and traumatic perineal injury (n = 8) following VBAC. Many of these ‘additional’ information points collected were discordant with best available evidence [2, 3].Figure 3


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

Whitelaw N, Bhattacharya S, McLernon D, Black M - BMC Pregnancy Childbirth (2014)

Website content as a percentage of potential pieces of information in support of each mode of delivery after caesarean birth compared with RCOG patient information document ‘Birth after previous caesarean: Information for you’.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4288659&req=5

Fig3: Website content as a percentage of potential pieces of information in support of each mode of delivery after caesarean birth compared with RCOG patient information document ‘Birth after previous caesarean: Information for you’.
Mentions: The number of websites demonstrating individual criteria supporting either VBAC or ERCS as outlined in the RCOG patient document was recorded (Table 2). The percentage score achieved in support of either VBAC or ERCS for each website was calculated (Figure 3). Only one of 48 websites mentioned 100% of points in favour of VBAC as mentioned in RCOG ‘gold standard’ patient information, with just two of 48 websites mentioning 100% of points in favour of ERCS. The most commonly addressed criterion was the increased risk of uterine scar rupture with VBAC (n = 45). Forty sites provided additional information in support of VBAC which not mentioned in the RCOG guidance. Most commonly cited examples included risks of wound infection (n = 21), haemorrhage (n = 18) and maternal surgical injury (n = 14) with ERCS. Twenty seven sites provided additional information in support of ERCS. Most commonly cited examples included the risk of incontinence (n = 7) and traumatic perineal injury (n = 8) following VBAC. Many of these ‘additional’ information points collected were discordant with best available evidence [2, 3].Figure 3

Bottom Line: A simple scoring method which categorised information into either supportive of VBAC (14 facts available) or ERCS (10 facts available) was employed and mean scores compared.Women searching for internet information on birth after previous caesarean are exposed to incomplete information.Origin of website has a significant effect on website content.

View Article: PubMed Central - PubMed

Affiliation: Division of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen AB25 2ZD, UK. mairead.black@abdn.ac.uk.

ABSTRACT

Background: Repeat caesarean sections make a substantial contribution to the overall caesarean section rate. It is important to understand what influences women to choose this option when the alternative of attempting vaginal birth after caesarean section is available. As many such women use the internet while seeking information on their options, the aim of this study was to assess content of websites on birth after previous caesarean and identify website characteristics which predict content.

Methods: An internet survey of the forty eight most frequently encountered websites retrieved from a search using various terms relating to birth after caesarean section via a popular search engine was performed. Websites were assessed for their content supportive of either vaginal birth after caesarean (VBAC) or elective repeat caesarean section (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 (14 facts available) or ERCS (10 facts available) was employed and mean scores compared. Poisson regression analysis was 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 ERCS were featured across the 48 websites, with corresponding scores in the five most frequently encountered websites being 40.0% (SD 13.9) and 66.0% (SD 20.7). Extent of featured information supportive of ERCS was related to country 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 to incomplete information. Origin of website has a significant effect on website content.

Show MeSH
Related in: MedlinePlus