Midwives’ views of an evidence-based intervention to reduce caesarean section rates in Ireland |
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| Institution: | 1. School of Psychology, Trinity College Dublin, Dublin, Ireland;2. School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland;1. School of Nursing Midwifery and Social Work, University of Queensland, Level 3 Chamberlain Building, St Lucia, Queensland, Australia;2. Central Coast Local Health District, Holden Street, Gosford, NSW 2250, Australia;3. North Sydney Local Health District, Coronation Street, Mona Vale, NSW 1660, Australia;4. School of Health Sciences, University of Skovde, Box 408, SE541 28, Sweden;5. Molly Wardaguga Research Centre, College of Nursing & Midwifery, Charles Darwin University, Level 11, East Building, 410 Ann St, Brisbane, Queensland, 4000, Australia;1. Australian Centre for Public and Population Health Research (ACPPHR), School of Public Health, Faculty of Health, University of Technology Sydney, PO Box 222, Jones St, Ultimo, 2007 NSW, Australia;2. Institute for Sustainable Futures, University of Technology Sydney, PO Box 222, Jones St, Ultimo, 2007 NSW, Australia;3. School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751 NSW, Australia;1. School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia;2. Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;3. Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institute, Sweden;4. Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia;5. Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia;1. School of Nursing and Midwifery, Western Sydney University, Locked bag 1797, Penrith, NSW 2751, Australia;2. Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, 2751 NSW, Australia;3. Graduate Research School and the Centre for Research in Mathematics and Data Science, Western Sydney University, Australia;1. University College South Denmark, Degnevej 16, 6705 Esbjerg Ø, Denmark;2. University of Southern Denmark, Department of Clinical Research, Winsløwparken 19, 5000 Odense, Denmark;3. Aarhus University Hospital, Unit for Perinatal Loss, Palle Juul-Jensens Blvd. 99, DK- 8200 Aarhus N, Denmark;4. University of Southern Denmark, Department of Public Health, J.B. Winsløwsvej 9B, 5000 Odense, Denmark |
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| Abstract: | ProblemA 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.BackgroundA 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.AimTo 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%.MethodsFollowing 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.FindingsFive 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.DiscussionThis 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.ConclusionThe study provided support for the evidence based ‘REDUCE’ intervention, which now needs to be tested empirically within this Irish population. |
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| Keywords: | Caesarean section Midwifery Prenatal care Qualitative methods Intervention testing |
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