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How can the VBAC rates be improved – according to midwives and obstetricians in six European countries.

Konferensbidrag (offentliggjort, men ej förlagsutgivet)
Författare Ingela Lundgren
Christina Nilsson
Evelien Van Limbeek
Katri Vehvilainen-Julkunen
Joan Lalor
Patricia Healy
Margaret Carroll
Mechthild Gross
Susanne Grylka-Baeschlin
Andrea Matterne
Jane Nicoletti
Sandra Morano
Cecily Begley
Publicerad i 31th ICM Trienníal Congress 18-22 June 2017
Publiceringsår 2017
Publicerad vid Institutionen för vårdvetenskap och hälsa
Språk en
Länkar www.icm2017.com/abstract_summary.ph...
Ämneskategorier Reproduktiv och perinatal omvårdnad, Omvårdnad, Annan medicin och hälsovetenskap

Sammanfattning

Background: The most common reason for caesarean section (CS) is repeat CS following previous CS. Vaginal birth after CS (VBAC) rates vary widely in different healthcare settings and countries. Interview studies with clinicians and women in three countries with high VBAC rates (Finland, Sweden and the Netherlands) and three countries with low VBAC rates (Ireland, Italy and Germany) are part of ‘OptiBIRTH’, a research project funded by EU aiming to increase VBAC rates across Europe through enhanced woman-centred maternity care. Purpose/Objective: To investigate the views of clinicians on factors of importance for improving VBAC rates. Method: Individual interviews and focus group interviews with clinicians in six countries with high and low VBAC rates were conducted during 2012–2013. 115 clinicians participated: 61 midwives and 54 physicians. Five questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language, translated into English, analysed together, and finally categories were validated in each country. Key Findings: According to midwives and obstetricians from countries with high VBAC rates, the important factors for improving the VBAC rate are a common approach, obstetricians’ final decision on the mode of birth, support during birth, and the strengthening of women’s trust in VBAC. Therefore the structure of the maternity care system in the country, cooperation between midwives and obstetricians, and the care offered during pregnancy and birth should be focused. Findings from the low VBAC countries will be presented at the conference and shows similarities in some aspects but also major differences. Discussion: Similarities and differences between factors of importance for improving the VBAC rate are related to both the care structure, and the views and attitudes of midwives and physicians, which has implications for the care of women post CS.

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