Midwives' views of an evidence-based intervention to reduce caesarean section rates in Ireland. Issue 6 (November 2022)

• Record Type: Journal Article
• Authors: Corrigan, Siobhán; Howard, Vivienne; Gallagher, Louise; Smith, Valerie; Hannon, Kathleen; Carroll, Margaret; Begley, Cecily
• Is Part Of: Women and birth. Volume 35:Issue 6(2022)
• Page Start: 536
• Page End: 546
• Publication Date: 2022-11
• Subjects: Caesarean section -- Midwifery -- Prenatal care -- Qualitative methods -- Intervention testing; Midwives -- Periodicals; Pregnancy -- Periodicals; Midwifery -- Periodicals; Pregnancy -- Periodicals; 618.2
• DOI: 10.1016/j.wombi.2022.01.002
• Languages: English
• ISSNs: 1871-5192

Abstract

Abstract: Problem: 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: 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: 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: 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: 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: 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: The study provided support for the evidence based 'REDUCE' intervention, which now needs to be tested empirically within this Irish population.