Midwives' views of an evidence-based intervention to reduce caesarean section rates in Ireland.
Caesarean section
Intervention testing
Midwifery
Prenatal care
Qualitative methods
Journal
Women and birth : journal of the Australian College of Midwives
ISSN: 1878-1799
Titre abrégé: Women Birth
Pays: Netherlands
ID NLM: 101266131
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
09
07
2021
revised:
03
11
2021
accepted:
03
01
2022
pubmed:
25
2
2022
medline:
8
11
2022
entrez:
24
2
2022
Statut:
ppublish
Résumé
A worldwide increase of caesarean section (CS) rates has been estimated at a rate of 4% per year and numerous interventions to reduce the rates have not been successful, perhaps because they are not acceptable to clinicians. A caesarean section (CS) can be a life-saving operation, but has been associated with short- and long-term risk factors and shown to affect subsequent pregnancies. To explore midwives' views on CS rates and evaluate the feasibility and acceptability of an evidence-based intervention programme (REDUCE) designed to decrease overall CS rates in Ireland by 7%. Following ethical approval, a qualitative exploratory design was used to seek midwives' views of the evidence-based intervention. A total of 28 midwives from one large tertiary maternity hospital took part in four focus group interviews. Data were analysed using thematic analysis. Five themes emerged, illustrating the midwives' views of what could be improved in the present system and how CS rates could be reduced in future. The themes included: (i) Induction of labour; (ii) Education; (iii) Auditing of practice; (iv) Clinical practice; (v) Midwife-Obstetrician collaboration. This study noted a rising CS rate year on year, with a rate of 37% at the time of the study, and the midwives voiced their very real concerns over the increased high rates. The study provided support for the evidence based 'REDUCE' intervention, which now needs to be tested empirically within this Irish population.
Sections du résumé
PROBLEM
OBJECTIVE
A worldwide increase of caesarean section (CS) rates has been estimated at a rate of 4% per year and numerous interventions to reduce the rates have not been successful, perhaps because they are not acceptable to clinicians.
BACKGROUND
BACKGROUND
A caesarean section (CS) can be a life-saving operation, but has been associated with short- and long-term risk factors and shown to affect subsequent pregnancies.
AIM
OBJECTIVE
To explore midwives' views on CS rates and evaluate the feasibility and acceptability of an evidence-based intervention programme (REDUCE) designed to decrease overall CS rates in Ireland by 7%.
METHODS
METHODS
Following ethical approval, a qualitative exploratory design was used to seek midwives' views of the evidence-based intervention. A total of 28 midwives from one large tertiary maternity hospital took part in four focus group interviews. Data were analysed using thematic analysis.
FINDINGS
RESULTS
Five themes emerged, illustrating the midwives' views of what could be improved in the present system and how CS rates could be reduced in future. The themes included: (i) Induction of labour; (ii) Education; (iii) Auditing of practice; (iv) Clinical practice; (v) Midwife-Obstetrician collaboration.
DISCUSSION
CONCLUSIONS
This study noted a rising CS rate year on year, with a rate of 37% at the time of the study, and the midwives voiced their very real concerns over the increased high rates.
CONCLUSION
CONCLUSIONS
The study provided support for the evidence based 'REDUCE' intervention, which now needs to be tested empirically within this Irish population.
Identifiants
pubmed: 35197224
pii: S1871-5192(22)00002-6
doi: 10.1016/j.wombi.2022.01.002
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
536-546Informations de copyright
Copyright © 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.