The Attitudes and Beliefs of Australian Midwives and Obstetricians About Birth Options and Labor Interventions.

Coates, D; Donnolley, N; Henry, A

The Attitudes and Beliefs of Australian Midwives and Obstetricians About Birth Options and Labor Interventions.

Coates, D

Donnolley, N Henry, A

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Journal of midwifery & women's health, 2020
Issue Date:: 2020-12-27

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Field	Value	Language
dc.contributor.author	Coates, D https://orcid.org/0000-0002-4463-7615
dc.contributor.author	Donnolley, N
dc.contributor.author	Henry, A
dc.date.accessioned	2021-01-07T03:48:30Z
dc.date.available	2020-08-12
dc.date.available	2021-01-07T03:48:30Z
dc.date.issued	2020-12-27
dc.identifier.citation	Journal of midwifery & women's health, 2020
dc.identifier.issn	1526-9523
dc.identifier.issn	1542-2011
dc.identifier.uri	http://hdl.handle.net/10453/145162
dc.description.abstract	<h4>Introduction</h4>The global rise in the rate of induction of labor and cesarean birth shows considerable unexplained variation both within and between countries. Prior research suggests that the extent to which women are engaged in the decision-making process about birth options, such as elective cesarean, induction of labor, or use of fetal monitoring, is heavily influenced by clinician beliefs and preferences. The aim of this study was to investigate the beliefs about labor interventions and birth options held by midwives and obstetric medical staff from 8 Sydney hospitals and assess how the health care providers' beliefs were associated with discipline or years of experience.<h4>Methods</h4>This is a survey study of midwives and obstetric staff that was distributed between November 2018 and July 2019. Modified from the previously validated birth attitudes survey for the Australian context, survey domains include (1) maternal choice and woman's role in birth, (2) safety by mode or place of birth, (3) attitudes toward cesarean birth for preventing urinary incontinence, (4) approaches to decrease cesarean birth rates, and (5) fears of birth mode. Responses were compared between professions and within professions by years of experience using Mann-Whitney U testing.<h4>Results</h4>A total of 217 midwives and 58 medical staff completed the survey (response rate, 30.5%). Midwifery staff responses generally favored a physiologic approach to birth, versus beliefs more in favor of intervention (particularly cesarean birth) among medical staff. There was interprofessional discrepancy on most items, particularly regarding safety of mode or place of birth and approaches to decrease cesarean birth rates. Within disciplines, there was more variation in medical staff attitudes than within the midwifery staff. No clinically important differences in beliefs by years of experience were noted.<h4>Discussion</h4>Clinicians need to be aware of their own beliefs and preferences about birth as a potential source of bias when counselling women, particularly when there are a range of treatment options and the evidence may not strongly favor one option over another. As both groups had similar perceptions about the importance of women's autonomy, shared decision-making training could help bridge belief gaps and improve care around birth decisions.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	Journal of midwifery & women's health
dc.relation.isbasedon	10.1111/jmwh.13168
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	1110 Nursing, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.title	The Attitudes and Beliefs of Australian Midwives and Obstetricians About Birth Options and Labor Interventions.
dc.type	Journal Article
utslib.location.activity	United States
utslib.for	1110 Nursing
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
dc.date.updated	2021-01-07T03:48:23Z
pubs.publication-status	Published

Abstract:

Introduction

The global rise in the rate of induction of labor and cesarean birth shows considerable unexplained variation both within and between countries. Prior research suggests that the extent to which women are engaged in the decision-making process about birth options, such as elective cesarean, induction of labor, or use of fetal monitoring, is heavily influenced by clinician beliefs and preferences. The aim of this study was to investigate the beliefs about labor interventions and birth options held by midwives and obstetric medical staff from 8 Sydney hospitals and assess how the health care providers' beliefs were associated with discipline or years of experience.

Methods

This is a survey study of midwives and obstetric staff that was distributed between November 2018 and July 2019. Modified from the previously validated birth attitudes survey for the Australian context, survey domains include (1) maternal choice and woman's role in birth, (2) safety by mode or place of birth, (3) attitudes toward cesarean birth for preventing urinary incontinence, (4) approaches to decrease cesarean birth rates, and (5) fears of birth mode. Responses were compared between professions and within professions by years of experience using Mann-Whitney U testing.

Results

A total of 217 midwives and 58 medical staff completed the survey (response rate, 30.5%). Midwifery staff responses generally favored a physiologic approach to birth, versus beliefs more in favor of intervention (particularly cesarean birth) among medical staff. There was interprofessional discrepancy on most items, particularly regarding safety of mode or place of birth and approaches to decrease cesarean birth rates. Within disciplines, there was more variation in medical staff attitudes than within the midwifery staff. No clinically important differences in beliefs by years of experience were noted.

Discussion

Clinicians need to be aware of their own beliefs and preferences about birth as a potential source of bias when counselling women, particularly when there are a range of treatment options and the evidence may not strongly favor one option over another. As both groups had similar perceptions about the importance of women's autonomy, shared decision-making training could help bridge belief gaps and improve care around birth decisions.

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http://hdl.handle.net/10453/145162