Maternal perceptions of cesarean birth care: A qualitative study to inform ERAS guideline development

Birth ◽  
2021 ◽  
Author(s):  
Krista Wollny ◽  
Amy Metcalfe ◽  
Crystal Corrigan ◽  
Ashley Drobot ◽  
Loreen Gilmour ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Guideline Development ◽  
Maternal Perceptions ◽  
Cesarean Birth

scholarly journals Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chitkasaem Suwanrath ◽  
Sopen Chunuan ◽  
Phawat Matemanosak ◽  
Sutham Pinjaroen
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Risk Perceptions ◽  
Care Center ◽  
Tertiary Care ◽  
Cesarean Birth ◽  
Positive Attitudes ◽  
Cesarean Births ◽  
Medical Indications ◽  
Superstitious Beliefs

Abstract Background Increasing worldwide rates of cesarean section are of global concern. In recent years, cesarean births upon maternal request have become a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications. Methods A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women who preferred cesarean birth, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019. Data were analyzed using content analysis. Results Maternal reasons for cesarean preference were classified into six main categories: fear of childbirth, safety concerns related to health risk perceptions, negative previous birth experiences, positive attitudes toward cesarean birth, access to biased information and superstitious beliefs in auspicious birth dates. Most women had more than one reason for opting cesarean birth. Conclusion Several reasons for cesarean birth preference have been elucidated. One striking reason was superstitious beliefs in auspicious birth dates, which are challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth in order to prevent or diminish unnecessary cesarean births.

scholarly journals International experiences in the development and implementation of guideline-based quality indicators: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039770
Author(s):  
Monika Nothacker ◽  
Marie Bolster ◽  
Mirco Steudtner ◽  
Katrin Arnold ◽  
Stefanie Deckert ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Quality Indicators ◽  
Patient Participation ◽  
Guideline Development ◽  
Qualitative Content Analysis ◽  
Evidence Base ◽  
Strategic Partnerships ◽  
Healthcare Settings ◽  
Registration Number ◽  
Individualised Care

ObjectivesEvidence-based clinical guidelines play an important role in healthcare and can be a valuable source for quality indicators (QIs). However, the link between guidelines and QI is often neglected and methodological standards for the development of guideline-based QI are still lacking. The aim of this qualitative study was to get insights into experiences of international authors with developing and implementing guideline-based QI.SettingWe conducted semistructured interviews via phone or skype (September 2017–February 2018) with guideline authors developing guideline-based QI.Participants15 interview participants from eight organisations in six European and North American countries.MethodsOrganisations were selected using purposive sampling with a maximum variation of healthcare settings. From each organisation a clinician and a methodologist were asked to participate. An interview guide was developed based on the QI development steps according to the ‘Reporting standards for guideline-based performance measures’ by the Guidelines International Network. Interviews were analysed using qualitative content analysis with deductive and inductive categories.ResultsInterviewees deemed a programmatic approach, involvement of representative stakeholders with clinical and methodological knowledge and the connection to existing quality improvement strategies important factors for developing QI parallel to or after guideline development. Methodological training of the developing team and a shared understanding of the QI purpose were further seen conducive. Patient participation and direct patient relevance were inconsistently considered important, whereas a strong evidence base was seen essential. To assess measurement characteristics interviewees favoured piloting, but often missed implementation. Lack of measurability is still experienced a serious limitation, especially for qualitative aspects and individualised care.ConclusionOur results suggest that developing guideline-based QI can succeed either parallel to or following the guideline process with careful planning and instruction. Strategic partnerships seem key for implementation. Patient participation and relevance, measurement of qualitative aspects and piloting are areas for further development.Trial registration numberGerman Clinical Trials Registry (DRKS00013006).

scholarly journals Maternal Perceptions of Cesarean Delivery Care: A Qualitative Study to inform ERAS Guideline Development

2019 ◽  
Author(s):  
Krista Wollny ◽  
Amy Metcalfe ◽  
Crystal Corrigan ◽  
Ashley Drobot ◽  
Loreen Gilmour ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cesarean Delivery ◽  
Enhanced Recovery ◽  
Guideline Development ◽  
Post Partum ◽  
Decision Aids ◽  
Structured Interview ◽  
Current Evidence ◽  
Delayed Cord Clamping ◽  
Mental Wellness

Abstract INTRODUCTION: Cesarean delivery (CD) is the most common inpatient surgical procedure; however, there are no internationally-accepted, standardized clinical guidelines. The Enhanced Recovery After Surgery (ERAS®) program aims to improve outcomes through the development of international guidelines (IG). The purpose of this study is to obtain and consolidate women’s experiences with CD to inform the development of an ERAS international guideline (IG). METHODS: Qualitative methods were used to assess the patient experience with current evidence-based CD protocols across operative phases. Twelve women who experienced CD were interviewed using an open-ended, semi-structured interview guide at six-weeks post-partum. Two researchers coded the emerging themes separately and compared findings. RESULTS: Women described feeling informed, but felt they did not have a choice. Pre-surgery, women wanted more information about the risks of CD. Pre-operatively, women expressed confusion with the procedures, but felt informed about local anaesthesia and thermoregulation. Post-CD, women felt informed about pain and nausea control; however, urinary catheter removal was delayed when compared to the ERAS recommendations. Information about post-partum infant care was not well communicated, as many women were uninformed about delayed cord-clamping and infant thermoregulation. DISCUSSION: This qualitative study provides opportunities to improve communication, the patient-provider relationship, and the overall satisfaction throughout the CD process. The findings support the implementation of patient decision aids and training with the shared decision model. The improved procedures recommended in the ERAS IG for CD have the potential to deliver significant improvements to patient satisfaction, mother-infant bonding and mental wellness.

scholarly journals Why do pregnant women prefer cesarean birth? : a qualitative study in a tertiary care center in Southern Thailand

2020 ◽  
Author(s):  
Chitkasaem Suwanrath ◽  
Sopen Chunuan ◽  
Phawat Matemanosak ◽  
Sutham Pinjaroen
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Care Center ◽  
Tertiary Care ◽  
Cesarean Birth ◽  
Superstitious Belief ◽  
Cesarean Births ◽  
Previous Birth ◽  
Southern Thailand ◽  
Medical Indications

Abstract Background: The increasing worldwide rate of cesarean sections is of global concern. In recent years, cesarean births upon maternal request have become both a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications.Methods: A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019, who preferred cesarean birth. Data were analyzed using content analysis.Results: Maternal reasons for cesarean preference were classified into six main categories including: fear of childbirth, safety concerns related to health risk perception, negative previous birth experience, positive attitude toward cesarean birth, access to biased information and superstitious belief in auspicious birth dates. Most women had more than one reason for opting cesarean birth. Conclusion: Several reasons for cesarean birth preference have been elucidated. One striking reason was a superstitious belief in auspicious birth dates, which is challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth, so as to prevent or diminish unnecessary cesarean births.

scholarly journals Women’s experiences of skin-to-skin cesarean birth compared to standard cesarean birth: a qualitative study

CMAJ Open ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. E834-E840
Author(s):  
Clea A. Machold ◽  
Susan E. O’Rinn ◽  
William H. McKellin ◽  
Gillian Ballantyne ◽  
Jon F.R. Barrett
Keyword(s):  
Qualitative Study ◽  
Women’S Experiences ◽  
Cesarean Birth ◽  
Women's Experiences ◽  
Skin To Skin

scholarly journals Current practices and challenges in adaptation of clinical guidelines: a qualitative study based on semistructured interviews

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053587
Author(s):  
Yang Song ◽  
Monica Ballesteros ◽  
Jing Li ◽  
Laura Martínez García ◽  
Ena Niño de Guzmán ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Clinical Guidelines ◽  
De Novo ◽  
Guideline Development ◽  
International Standards ◽  
Adaptation Process ◽  
Implementation Barriers ◽  
Framework Analysis ◽  
Guideline Adaptation ◽  
Semistructured Interviews

ObjectiveThis study aims to better understand the current practice of clinical guideline adaptation and identify challenges raised in this process, given that published adapted clinical guidelines are generally of low quality, poorly reported and not based on published frameworks.DesignA qualitative study based on semistructured interviews. We conducted a framework analysis for the adaptation process, and thematic analysis for participants’ views and experiences about adaptation process.SettingNine guideline development organisations from seven countries.ParticipantsGuideline developers who have adapted clinical guidelines within the last 3 years. We identified potential participants through published adapted clinical guidelines, recommendations from experts, and a review of the Guideline International Network Conference attendees’ list.ResultsWe conducted ten interviews and identified nine adaptation methodologies. The reasons for adapting clinical guidelines include developing de novo clinical guidelines, implementing source clinical guidelines, and harmonising and updating existing clinical guidelines. We identified the following core steps of the adaptation process (1) selection of scope and source guideline(s), (2) assessment of source materials (guidelines, recommendations and evidence level), (3) decision-making process and (4) external review and follow-up process. Challenges on the adaptation of clinical guidelines include limitations from source clinical guidelines (poor quality or reporting), limitations from adaptation settings (lacking resources or skills), adaptation process intensity and complexity, and implementation barriers. We also described how participants address the complexities and implementation issues of the adaptation process.ConclusionsAdaptation processes have been increasingly used to develop clinical guidelines, with the emergence of different purposes. The identification of core steps and assessment levels could help guideline adaptation developers streamline their processes. More methodological research is needed to develop rigorous international standards for adapting clinical guidelines.

scholarly journals Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand

2020 ◽  
Author(s):  
Chitkasaem Suwanrath ◽  
Sopen Chunuan ◽  
Phawat Matemanosak ◽  
Sutham Pinjaroen
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Risk Perceptions ◽  
Care Center ◽  
Tertiary Care ◽  
Cesarean Birth ◽  
Positive Attitudes ◽  
Cesarean Births ◽  
Medical Indications ◽  
Superstitious Beliefs

Abstract AbstractBackground: The increasing worldwide rates of cesarean section are of global concern. In recent years, cesarean births upon maternal request have become a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications.Methods: A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women who preferred cesarean birth, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019. Data were analyzed using content analysis.Results: Maternal reasons for cesarean preference were classified into six main categories: fear of childbirth, safety concerns related to health risk perceptions, negative previous birth experiences, positive attitudes toward cesarean birth, access to biased information and superstitious beliefs in auspicious birth dates. Most women had more than one reason for opting cesarean birth. Conclusion: Several reasons for cesarean birth preference have been elucidated. One striking reason was superstitious beliefs in auspicious birth dates, which are challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth, so as to prevent or diminish unnecessary cesarean births.

scholarly journals Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand

2021 ◽  
Author(s):  
Chitkasaem Suwanrath ◽  
Sopen Chunuan ◽  
Phawat Matemanosak ◽  
Sutham Pinjaroen
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Risk Perceptions ◽  
Care Center ◽  
Tertiary Care ◽  
Cesarean Birth ◽  
Positive Attitudes ◽  
Cesarean Births ◽  
Medical Indications ◽  
Superstitious Beliefs

Abstract Background: Increasing worldwide rates of cesarean section are of global concern. In recent years, cesarean births upon maternal request have become a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications.Methods: A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women who preferred cesarean birth, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019. Data were analyzed using content analysis.Results: Maternal reasons for cesarean preference were classified into six main categories: fear of childbirth, safety concerns related to health risk perceptions, negative previous birth experiences, positive attitudes toward cesarean birth, access to biased information and superstitious beliefs in auspicious birth dates. Most women had more than one reason for opting cesarean birth. Conclusion: Several reasons for cesarean birth preference have been elucidated. One striking reason was superstitious beliefs in auspicious birth dates, which are challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth in order to prevent or diminish unnecessary cesarean births.

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