Background: Caesarean section (CS) rates are increasing in both developed and developing
countries. Vaginal birth after cesarean (VBAC) is an important option for reducing the CS rate.
Objective: The purpose of this study is to explore clinicians' and midwives' views of factors influencing
decision-making for VBAC based on the theory of planned behavior.
Methods: This qualitative study was carried out in Urmia- Iran, during 2017-2018. Data were collected
using in-depth semi-structured interviews with 21 obstetricians and midwives. Participants
were selected among governmental hospitals through purposeful sampling until data saturation was
reached. Data were analyzed through a directed content analysis approach using the MAXQDA
software version 10.
Results: Three themes and seven sub-themes including 1. "attitude toward VBAC": positive attitude
and negative attitude; 2. "control belief": organizational support, fear, and self-efficacy; and 3. "subjective
norms": peer recommendation and maternal perceived pressure were emerged from data
Conclusion: Clinicians' and midwives' positive attitude and clinicians' self-efficacy could reinforce
their intentions to select VBAC and support the mother. Insufficient organization support, clinicians'
and midwives' negative attitude, clinicians' and women's fear, clinicians' peer recommendation and
pressure of outside sources, which is perceived by mothers, could be barrier factors for VBAC.