• Christina Nilsson, Joan Lalor, Cecily Begley, Margaret Carroll, Mechthild M Gross, Susanne Grylka-Baeschlin, Ingela Lundgren, Andrea Matterne, Sandra Morano, Jane Nicoletti, and Patricia Healy.
• Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden. Electronic address: christina.nilsson@hb.se.
• Women Birth. 2017 Dec 1; 30 (6): 481-490.

Problem And BackgroundVaginal birth after caesarean section is a safe option for the majority of women. Seeking women's views can be of help in understanding factors of importance for achieving vaginal birth in countries where the vaginal birth rates after caesarean is low.AimTo investigate women's views on important factors to improve the rate of vaginal birth after caesareanin countries where vaginal birth rates after previous caesarean are low.MethodsA qualitative study using content analysis. Data were gathered through focus groups and individual interviews with 51 women, in their native languages, in Germany, Ireland and Italy. The women were asked five questions about vaginal birth after caesarean. Data were translated to English, analysed together and finally validated in each country.FindingsImportant factors for the women were that all involved in caring for them were of the same opinion about vaginal birth after caesarean, that they experience shared decision-making with clinicians supportive of vaginal birth, receive correct information, are sufficiently prepared for a vaginal birth, and experience a culture that supports vaginal birth after caesarean.Discussion And ConclusionWomen's decision-making about vaginal birth after caesarean in these countries involves a complex, multidimensional interplay of medical, psychosocial, cultural, personal and practical considerations. Further research is needed to explore if the information deficit women report negatively affects their ability to make informed choices, and to understand what matters most to women when making decisions about vaginal birth after a previous caesarean as a mode of birth.Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

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