The influence of individual provider characteristics and attitudes on caesarean section decision-making: a global review

Mulchandani, Ranya; Power, Harvinder S; Cavallaro, Francesca

doi:10.1080/01443615.2019.1587603

Cited by 8 publications

(6 citation statements)

References 58 publications

(90 reference statements)

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“…Tawse et al ( 24 ) report that in the case of primiparous mothers, the risk of at-birth asphyxia is three times higher than for multiparous mothers {ORa: 3.10 [95% IC (1.51–6.38)]}. Their results are similar to those obtained by Igboanugo et al ( 25 ), who observed that first-time mothers showed an increased odds ratio for at-birth asphyxia (OR: 2.64). Ilah et al ( 26 ), Ensing et al ( 22 ), Crovetto et al ( 16 ), or Liljestrom et al ( 27 ) confirm a higher incidence of adverse perinatal outcomes, fetal asphyxia, and neonatal hypoxia in primiparous women.…”

Section: Discussionsupporting

confidence: 64%

Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth

2021

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Background: Perinatal asphyxia is a significant contributing factor for neonatal morbidity and mortality. The aim of this study was to investigate the clinical factors associated with umbilical artery pH variability and fetal acidosis at birth.Methods: This is a single center cross-sectional study in a public regional hospital in southeastern Spain from January to December 2019. The reference population was 1.655 newborns, final sample of 312 experimental units with validated values of umbilical cord blood pH.Results: Factors such as gestational age at term (X̄at-term: 7.26 ± 0.08-X̄no-at−term: 7.31 ± 0.05, p: 0.00), primiparity (X̄primiparity: 7.24 ± 0.078-X̄multiparity: 7.27 ± 0.08, p: 0.01), induced labor (X̄induced: 7.24 ± 0.07-X̄spontaneous: 7.26 ± 0.081, p: 0.02), vaginal delivery (X̄vaginal:7.25 ± 0.08-X̄cesarean:7.27 ± 0.07, p: 0.01), and prolonged dilation duration (X̄AboveAverage: 7.22 ± 0.07-X̄BelowAverage: 7.27 ± 0.08, p: 0.00), expulsion duration (X̄AboveAverage: 7.23 ± 0.07-X̄BelowAverage: 7.26 ± 0.08, p: 0.01), and total labor duration (X̄AboveAverage: 7.23 ± 0.07-X̄BelowAverage: 7.27 ± 0.08, p: 0.00) are associated with a decrease in umbilical artery pH at birth. However, only three factors are associated with acidosis pH (<7.20) of the umbilical artery at birth: the induction of labor [OR: 1.74 (95% CI: 0.98–3.10); p: 0.04], vaginal delivery [OR: 2.09 (95% CI: 0.95–4.61); p: 0.04], and total duration of labor [OR: 2.06 (95% CI: 1.18–3.57); p: 0.01].Conclusions: Although several factors may affect the variability of umbilical artery pH at birth by decreasing their mean values (gestational age, primiparity, induced labor, vaginal delivery and prolonged: dilation duration, expulsion duration and total labor duration), only induction of labor, vaginal delivery and total duration of labor are associated with an acidosis (<7.20) of same.

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Section: Discussionsupporting

confidence: 64%

Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth

2021

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“…A high rate of CS poses a significant problem for the medical community in many countries and is even considered a global epidemic [ 21 ]. Several studies focused on possible causes of high and still-increasing CS rates have found that variability in CS rates is driven by differences in clinician knowledge, values, and beliefs, as well as cultural and social factors and the medicalization of pregnancy and births [ 17 , 18 , 22 , 23 ]. We thus hypothesize that attitudes and knowledge of medical students—future clinicians—concerning VB and CS is the effect of all aforementioned factors but additionally, and perhaps primarily, of standardized theoretical and practical education as the foundation for their future practices.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Vaginal/Cesarean Birth Attitudes among Medical Students

et al. 2022

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Background: Polish perinatal care is facing a high, ever-increasing cesarean section (CS) rate that is currently at 43%. Crucially, reports have revealed that the attitudes, experiences, and skills of clinicians directly contribute to this elevated CS rate. Methods: This cross-sectional study, which included 748 Polish medical students, aimed to identify medical students’ attitudes regarding birth methods. A descriptive questionnaire was distributed via the academic email addresses of surveyed medical students. Group comparisons were performed using Welch’s t-test for continuous data or a Chi-squared test for categorical data. We also used the Mann–Whitney U test and Kruskal–Wallis H test. Results: Midwifery students (96.2%) were the most unified group of students, with most agreeing that VB (vaginal birth) presents a safer option for women at low risk for VB-related complications vs. cesarean section. Of Medical Faculty students, 68% believed that fewer complications typically occur during vaginal birth than during CS. Students in their final vs. initial years of study furthermore considered VB more beneficial for women than CS. Conclusions: An important factor identified at the individual clinician level is the presence of leadership and executive support. For medical students, we can interpret this as support from their trainers and supervisors.

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“…births, and the attitudes of clinicians (including stress coping strategies). [14,15,20] We hypothesise that medical students' attitudes and knowledge about the VB and CB is the effect of all mentioned factors but mainly of standardised theoretical and practical education as a foundation for their future practice.…”

Section: Demographic Characteristics Of the Medical Studentsmentioning

confidence: 99%

Multicentre study on stress coping strategies and vaginal/caesarean birth opinions among medical students

Michalik

Zdun-Ryżewska

Pracowity

et al. 2022

Preprint

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Background. Polish perinatal care is facing a high and increasing caesarean birth (CB) rate, which is at 43%. Stress coping strategies among professionals can be important factors in the decision-making for CB. Study aimed to identify opinions associated with a birth route and stress coping strategies. Methods. This cross-sectional, exploratory study included 748 Polish medical students and aimed to identify opinions associated with a birth route and stress coping strategies among medical students. A descriptive questionnaire was distributed online. Group comparisons were performed using Welch’s t-test for continuous data or the χ2 test for categorical data. Spearman’s ρ coefficient was used. Results. Statistically, first- and second-year students thought that every woman can choose vaginal birth (VB) or CB. Students in their final years of study considered that VB is more beneficial for women at low risk of VB-related complications. The respondents who reported that VB is safer, women recover faster after it, and women should not be able to choose VB/CB on their own exhibited statistically significantly lower helplessness levels and greater use of religion as a stress coping strategy. Those who were more helpless and less religious were also less convinced of the safety of VB, believed in faster recovery after CB and expressed that the woman herself should decide how to give birth. Conclusion. Stress coping strategies seem to be related to the understanding of the childbirth process and the set of attitudes connected with it. Helplessness and religiosity turned out to be the most important factors in this area. The connection between helplessness (stress coping strategy) and estimation of greater pain during VB than CB obtained in our research, is a phenomenon that may lead students with these characteristics to prefer and recommend CB in their future practice.

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The influence of individual provider characteristics and attitudes on caesarean section decision-making: a global review

Cited by 8 publications

References 58 publications

Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth

Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth

Factors Associated with Vaginal/Cesarean Birth Attitudes among Medical Students

Multicentre study on stress coping strategies and vaginal/caesarean birth opinions among medical students

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