Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section) : a study from countries with low VBAC rates

Lundgren, Ingela; Healy, Patricia; Carroll, Margaret; Begley, Cecily; Matterne, Andrea; Gross, Mechthild Maria; Grylka-Baeschlin, Susanne; Nicoletti, Jane; Morano, Sandra; Nilsson, Christina; Lalor, Joan

doi:10.21256/zhaw-4287

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-4287

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section) : a study from countries with low VBAC rates
Authors:	Lundgren, Ingela Healy, Patricia Carroll, Margaret Begley, Cecily Matterne, Andrea Gross, Mechthild Maria Grylka-Baeschlin, Susanne Nicoletti, Jane Morano, Sandra Nilsson, Christina Lalor, Joan
DOI:	10.21256/zhaw-4287 10.1186/s12884-016-1144-0
Published in:	BMC Pregnancy & Childbirth
Volume(Issue):	16
Issue:	350
Page(s):	1
Pages to:	10
Issue Date:	2016
Publisher / Ed. Institution:	BioMed Central
ISSN:	1471-2393
Language:	English
Subjects:	Clinicians; Content analysis; Focus groups; Midwifery; Qualitative study; VBAC; Cesarean section, repeat; Decision making; Focus groups; Health personnel; Parturition; Pregnancy; Vaginal birth after cesarean; Health knowledge, attitudes, practice
Subject (DDC):	618.4: Childbirth
Abstract:	Background: Caesarean section (CS) rates are increasing worldwide and the most common reason is repeat CS following previous CS. For most women a vaginal birth after a previous CS (VBAC) is a safe option. However, the rate of VBAC differs in an international perspective. Obtaining deeper knowledge of clinicians’ views on VBAC can help in understanding the factors of importance for increasing VBAC rates. Focus group interviews 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”, an ongoing research project. The study reported here aims to explore the views of clinicians from countries with low VBAC rates on factors of importance for improving VBAC rates. Methods: Focus group interviews were held in Ireland, Italy and Germany. In total 71 clinicians participated in nine focus group interviews. Five central questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language and then translated into English. All data were then analysed together and final categories were validated in each country. Results: The findings are presented in four main categories with several sub-categories: 1) “prameters for VBAC”, including the importance of the obstetric history, present obstetric factors, a positive attitude among those who are centrally involved, early follow-up after CS and antenatal classes; 2) “organisational support and resources for women undergoing a VBAC”, meaning a successful VBAC requires clinical expertise and resources during labour; 3) “fear as a key inhibitor of successful VBAC”, including understanding women’s fear of childbirth, clinicians’ fear of VBAC and the ways that clinicians’ fear can be transferred to women; and 4) “shared decision making – rapport, knowledge and confidence”, meaning ensuring consistent, realistic and unbiased information and developing trust within the clinician-woman relationship. Conclusions: The findings indicate that increasing the VBAC rate depends on organisational factors, the care offered during pregnancy and childbirth, the decision-making process and the strategies employed to reduce fear in all involved.
URI:	https://digitalcollection.zhaw.ch/handle/11475/8172
Fulltext version:	Published version
License (according to publishing contract):	CC BY 4.0: Attribution 4.0 International
Departement:	School of Health Sciences
Organisational Unit:	Institute of Midwifery and Reproductive Health (IHG)
Appears in collections:	Publikationen Gesundheit

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Lundgren, I., Healy, P., Carroll, M., Begley, C., Matterne, A., Gross, M. M., Grylka-Baeschlin, S., Nicoletti, J., Morano, S., Nilsson, C., & Lalor, J. (2016). Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section) : a study from countries with low VBAC rates. BMC Pregnancy & Childbirth, 16(350), 1–10. https://doi.org/10.21256/zhaw-4287

Lundgren, I. et al. (2016) ‘Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section) : a study from countries with low VBAC rates’, BMC Pregnancy & Childbirth, 16(350), pp. 1–10. Available at: https://doi.org/10.21256/zhaw-4287.

I. Lundgren et al., “Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section) : a study from countries with low VBAC rates,” BMC Pregnancy & Childbirth, vol. 16, no. 350, pp. 1–10, 2016, doi: 10.21256/zhaw-4287.

LUNDGREN, Ingela, Patricia HEALY, Margaret CARROLL, Cecily BEGLEY, Andrea MATTERNE, Mechthild Maria GROSS, Susanne GRYLKA-BAESCHLIN, Jane NICOLETTI, Sandra MORANO, Christina NILSSON und Joan LALOR, 2016. Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section) : a study from countries with low VBAC rates. BMC Pregnancy & Childbirth. 2016. Bd. 16, Nr. 350, S. 1–10. DOI 10.21256/zhaw-4287

Lundgren, Ingela, Patricia Healy, Margaret Carroll, Cecily Begley, Andrea Matterne, Mechthild Maria Gross, Susanne Grylka-Baeschlin, et al. 2016. “Clinicians’ Views of Factors of Importance for Improving the Rate of VBAC (Vaginal Birth after Caesarean Section) : A Study from Countries with Low VBAC Rates.” BMC Pregnancy & Childbirth 16 (350): 1–10. https://doi.org/10.21256/zhaw-4287.

Lundgren, Ingela, et al. “Clinicians’ Views of Factors of Importance for Improving the Rate of VBAC (Vaginal Birth after Caesarean Section) : A Study from Countries with Low VBAC Rates.” BMC Pregnancy & Childbirth, vol. 16, no. 350, 2016, pp. 1–10, https://doi.org/10.21256/zhaw-4287.