“It's your body... so it's just nice to know what they're putting in it” A qualitative study of Women’s Views on Antibiotics at Caesarean Section (WOVAN)

Abstract Background: Over 30% of UK babies are born by caesarean section (CS) and infection after CS is common. Women’s experiences of and views on the management of infection after CS is relatively under explored in the qualitative literature. The aim of this study was to explore women’s views and experiences of (1) infection after caesarean section including (2) measures taken to prevent infection such as antibiotics, (3) the use of additional antibiotics and infection prevention measures in research, and (4) identifying infection after discharge home. Methods: A descriptive qualitative study reported in accordance with Consolidated criteria for Reporting Qualitative research (COREQ) guidelines. Recruitment occurred via social media, and data-collected using semi-structured interviews aided by an evidence informed topic guide. Written or recorded verbal informed consent was obtained. A codebook thematic analysis approach was used to code transcripts, interpret themes and inform a conceptual model of the findings. Results: Thirteen women were interviewed between December 2021 and March 2022. All women included had had a CS within the last two years, and four had an infection after their CS. For the majority of participants this was their first CS (n=10), they were between 30-40 years old (n=10) and they identified as white British (n=10). Participants had experiences of both planned (n=6) and emergency CS (n=7). Women's experiences of recovery and infection after CS were influenced by their interactions with maternity care; key themes in how women perceived their experience of CS and infection were ‘knowing my body’, information-sharing and effective communication. Secondary factors such as support and dependents also influenced their interpretation of their overall care experience. There was willingness to take part in future research of interventions to reduce the risk of infection after CS. Conclusions: Further work is needed to develop antenatal information sharing and postnatal follow-up pathways to improve experiences. It is important to ensure women’s voices remain central to future infection prevention research.