Improving the organisation of maternal health service delivery, and optimising childbirth, by increasing vaginal birth after caesarean section (VBAC) through enhanced women-centred care

Conditions

Pregnancy Pregnancy and Childbirth Vaginal birth

Clarke M, Devane D, Gross MM, Morano S, Lundgren I, Sinclair M, Putman K, Beech B, Vehviläinen-Julkunen K, Nieuwenhuijze M, Wiseman H, Smith V, Daly D, Savage G, Newell J, Simpkin A, Grylka-Baeschlin S, Healy P, Nicoletti J, Lalor J, Carroll M, van Limbeek E, Nilsson C, Stockdale J, Fobelets M, Begley C.

2020-03-0615 citations

10.1186/s12884-020-2829-y

Process evaluation for OptiBIRTH, a randomised controlled trial of a complex intervention designed to increase rates of vaginal birth after caesarean section

Patricia Healy, Valerie Smith, Gerard Savage, Mike Clarke, Declan Devane et al. (14 authors)

Trials2018-01-0522 citations

10.1186/s13063-017-2401-x

Improving the organisation of maternal health service delivery and optimising childbirth by increasing vaginal birth after caesarean section through enhanced women-centred care (OptiBIRTH trial): study protocol for a randomised controlled trial (ISRCTN10612254)

Mike Clarke, Gerard Savage, Valerie Smith, Déirdre Daly, Declan Devane et al. (11 authors)

Trials2015-11-3036 citations

10.1186/s13063-015-1061-y

Interventions

1. Evidence-based education of women and clinicians, introduction of communities of practice (women and clinicians sharing knowledge), opinion leaders, audit and peer review of caesarean sections in e

Eligibility

Sex/Gender

Female

Inclusion criteria

Inclusion criteria: 1. Pregnant women aged over 18 years 2. Who have had one previous caesarean section 3. Who speak a language for which translation is available 4. Who give their consent

Exclusion criteria

Exclusion criteria: Women for whom a vaginal birth is contraindicated

Design outcomes

Primary

Measure	Time frame
Change from baseline in each hospital in the proportion of women who have had one previous caesarean section who have a vaginal birth during the study	—

Secondary

Measure	Time frame
These secondary outcome measures will be collected using routine data where possible, will require the identification of reliable, robust and feasible measurement instruments, and might be collected on a sub-set of the participating women. 1. Gestational age at birth 2. Length of labour 3. Emotional well-being, feelings of anxiety, control, satisfaction with care and perception of involvement in care, during pregnancy and the postnatal period 4. Intrapartum interventions (induction or augmentation of labour, use of epidural and fetal monitoring, mode of birth) 5. Maternal morbidities during pregnancy and the postnatal period (for example, pain, postpartum haemorrhage, wound infection, abdominal pain, depression) 6. Neonatal morbidities (resuscitation, Apgar scores, admission to intensive care) 7. Breastfeeding 8. Length of hospital stay (mother and infant) 9. Readmission Health economic analyses will be done using data on clinical outcomes, direct costs (such as length of stay and antibiotic use) and indirect costs (such as productivity loss) during pregnancy and postnatal period. The study will also seek to assess adherence to guidelines and practice protocols, adherence to intervention quantity and quality, and midwife-centred variables; to compare and contrast findings across the different hospitals.	—

Measure

Time frame

These secondary outcome measures will be collected using routine data where possible, will require the identification of reliable, robust and feasible measurement instruments, and might be collected on a sub-set of the participating women. 1. Gestational age at birth 2. Length of labour 3. Emotional well-being, feelings of anxiety, control, satisfaction with care and perception of involvement in care, during pregnancy and the postnatal period 4. Intrapartum interventions (induction or augmentation of labour, use of epidural and fetal monitoring, mode of birth) 5. Maternal morbidities during pregnancy and the postnatal period (for example, pain, postpartum haemorrhage, wound infection, abdominal pain, depression) 6. Neonatal morbidities (resuscitation, Apgar scores, admission to intensive care) 7. Breastfeeding 8. Length of hospital stay (mother and infant) 9. Readmission Health economic analyses will be done using data on clinical outcomes, direct costs (such as length of stay and antibiotic use) and indirect costs (such as productivity loss) during pregnancy and postnatal period. The study will also seek to assess adherence to guidelines and practice protocols, adherence to intervention quantity and quality, and midwife-centred variables; to compare and contrast findings across the different hospitals.

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Countries

Germany, Ireland, Italy

Outcome results

None listed