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HEALTHCARE PROFESSIONALS’ ATTITUDES TOWARDS VAGINAL BIRTH AFTER CESAREAN SECTION; İSTANBUL EXAMPLE

Year 2022, Volume: 7 Issue: 3, 258 - 267, 25.12.2022
https://doi.org/10.33457/ijhsrp.1131379

Abstract

Rapidly increasing cesarean birth rates around the world continue to cause concern. Repeated cesarean sections are the most important causes of this increase. Vaginal birth after cesarean section (VBAC) is a good solution, but is not used widely enough in clinical practice. This cross-sectional descriptive study aimed to determine the attitudes of healthcare professionals towards VBAC and the factors that affect them. The study was conducted at a maternity hospital in Istanbul and sample included 254 healthcare professionals. The data were collected using a personal information form and the VBAC Attitudes Form. Percentages, means, Pearson’s chi-squared test, the Kruskal-Wallis H test and the Mann-Whitney U test were used. The threshold for statistical significance was p<0.05. Of the participants, 66.1% saw VBAC as an effective mode of birth, 68.5% thought that it should be widely used in Turkey, and 85.4% thought that women have the right to request VBAC. But only 53.5% knew that Turkey has national VBAC management guidelines, and 37.8% would recommend VBAC to pregnant women. Their mean score for seeing VBAC as a safe mode of birth was 5.15±2.19 (min:0-max:10), and the score for willingness to work on VBAC teams was 4.95±3.42 (min.0-max:10). The factors that affected their attitudes towards VBAC were: being less than 25 years old, higher education levels, one to three years of professional experience and being female(p<0.05). The participants had positive attitudes about VBAC in theory, but remained reluctant about it in their clinical practice. The participants who were less than 25 years old, female, had higher education levels and had one to three years of professional experience had more positive attitudes towards VBAC.

Supporting Institution

None

Project Number

None

Thanks

The authors are grateful for the healthcare professionals who so willingly gave their time and participated in this study.

References

  • Boerma, T., Ronsmans, C., Melesse, D.Y., Barros, A.J.D., Barros, F.C., Juan, L.,…&Temmerman, M., "Global epidemiology of use of and disparities in caesarean sections", Lancet, 13:392(10155), 1341-1348, 2018. https://doi:10.1016/S0140-6736(19)30698-1.
  • World Health Organization (2015). WHO Statement on caesarean section rates. [Online]. Available From: https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/.
  • Visser, G.H.A., Ayres-de-Campos, D., Barnea, E.R., Bernis, L., Renzo, G.C.D., Vidarte, M.F.E., … &Wallani, S., "FIGO position paper: how to stop the caesarean section epidemic", Lancet, 13:392(10155), 1286-1287, 2018. https://doi:10.1016/S0140-6736(18)32113-5.
  • Ye, J., Zhang, J., Mikolajczyk, R., Gülmezoğlu, A.M., Betran, A.P., "Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data", BJOG, 123(5),745-53, 2016. https://doi:10.1111/1471-0528.13592.
  • Cegolon, L., Mastrangelo, G., Maso, G., Dal Pozzo, G., Ronfani, L., Cegolon, A., "Understanding factors leading to primary cesarean section and vaginal birth after cesarean delivery in the Friuli- Venezia Giulia Region (North-Eastern Italy), 2005–2015". Sci Rep. 10(1),1-18, 2020. https://doi.org/10.1038/s41598-019-57037-y.
  • Montoya-Williams, D., Lemas, D.J., Spiryda, L., Patel, K., Neu, J., Carson, T.L., "What are optimal cesarean section rates in the U.S. and how do we get there? A review of evidence-based recommendations and interventions", J Women’s Health, 26(12), 1285-1291, 2017. https://doi:10.1089/jwh.2016.6188.
  • Liabsuetrakul, T., Sukmanee, J., Thungthong, J., Lumbiganon, P., "Trend of cesarean section rates and correlations with adverse maternal and neonatal outcomes: A secondary analysis of Thai universal coverage scheme data", AJP Rep, 9(4), 328–336, 2019. https://doi:10.1055/s-0039-1697656.
  • Molina, G., Weiser, T.G., Lipsitz, S.R., Esquivel, M.M., Uribe-Leitz, T., Azad, T., …& Haynes, A.B., "Relationship between cesarean delivery rate and maternal and neonatal mortality", JAMA, 314(21), 2263–2270, 2015. https://doi:10.1001/jama.2015.15553.
  • Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, …& Temmerman, M., "Short-term and long-term effects of caesarean section on the health of women and children", Lancet, 13;392 (10155), 1349-1357, 2018. https://doi:10.1016/S0140-6736(18)31930-5.
  • de Elejalde, R., Giolito, E., (2019). More hospital choices, more c-sections: Evidence from Chile. IZA Institute of Labor Economics Discussion Paper Series, No. 12297. [Online]. Available from: http://ftp.iza.org/dp12297.pdf.
  • American College of Obstetricians and Gynecologists., "ACOG Practice Bulletin No. 205: Vaginal birth after cesarean delivery", Obstetrics & Gynecology, 133(2), 110-127, 2019. https://doi:10.1097/AOG.0000000000003078.
  • Black. C., Kaye, J., Jick, H, "Cesarean delivery in the United Kingdom: time trends in the general practice research database", Obstet Gynecol, 106(1):151-155, 2005. https://doi:151–5.10.1097/01.AOG.0000160429.22836.
  • Landon, M.B., Hauth, J.C., Leveno, K.J., Spong, C.Y., Leindecker, S., Varner, M.W., …& Gabbe, S.G., "Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery", The New England Journal of Medicine. 2004; 351(25): 2581-2589.
  • Lundgren, I., van Limbeek, E., Vehvilainen-Julkunen, K., "Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): A qualitativestudy from countries with high VBAC rates", BMC Pregnancy and Childbirth, 15:196, 2015. https://doi:10.1186/s12884-015-0629-6.
  • Lundgren, I., Healy, P., Caroll, M., Begley, C., Matterne, A., Gross, M.M., …& Lalor, J., "Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): A study from countries with low VBAC rates", BMC Pregnancy and Childbirth, 16:350. 2016. https://doi:10.1186/s12884-016-1144-0.
  • Lundgren, I., Morano, S., Nillson, C., Sinclair, M., Begley, C., "Cultural perspectives on vaginal birth after previous caesarean section in countries with high and low rates — A hermeneutic study", Women and Birth, 33: 339–347, 2020. https://doi.org/10.1016/j.wombi.2019.07.300.
  • Davis, D., Homer, S.C., Clack, D., Turkmani, S., Foureur, M., "Choosing vaginal birth after caesarean section: Motivating factors", Midwifery, 88, 102766, 2020. https://doi.org/10.1016/j.midw.2020.102766.
  • Firoozi, M., Tara, F., Ahanchian, M., Roudsari, R.B., "Health care system barriers to vaginal birth after cesarean section: A qualitative study", Iranian Journal of Nursing and Midwifery Research, 25(3), 202-211, 2021. https://doi.org/10.4103/ijnmr.IJNMR_150_19.
  • Linn, G., Ying, Y., Chang, K., "The determinants of obstetricians’ willingness to undertake delivery by vaginal birth after cesarean section in Taiwan", Therapeutics and Clinical Risk Management, 15: 991–1002, 2019; https://doi.org/10.2147/TCRM.S205009.
  • Organisation for Economic Cooperation and Development (2018), Health care use - Caesarean sections- OECD Data. [Online]. Available from: https://data.oecd.org/healthcare/caesarean-sections.htm.
  • Republic of Türkiye Ministry of Health (2014), Birth and Cesarean Section Management Guide. [Online]. Available from: https://dosyamerkez.saglik.gov.tr/Eklenti/6407,dogum-ve-sezaryen-eylemi-yonetim-rehberipdf.pdf?
  • Hacettepe University (2018), Turkey Demographic and Health Survey. [Online]. Available from: http://www.hips.hacettepe.edu.tr/tnsa2018/rapor/TNSA2018_ana_Rapor.pdf.
  • Republic of Türkiye Ministry of Health (2018), Health Indicators of Turkey. [Online]. Available from: https://khgmozellikli.saglik.gov.tr/svg/inc/saglik_gostergeleri.pdf.
  • Uçar, T., Derya, Y.A., Barut, S., Güney, E., Sabancı, E., Unver, H., "Opinions of labor professionals about vaginal birth after cesarean in Turkey. International Journal of Caring Sciences, 11(2), 1043-49, 2018.
  • Ünsal, A.Ş., Kavalak, O., Dönmez, S., Öztürk, R., Güleç, D., Çelik, N., …& Weller, B.K., "Opinions and knowledge of healthcare professionals on vaginal birth after caesarean section", JACSD, 11: 119-133, 2017. https://doi:10.17367/JACSD.2017.3.4.
  • Wewers, M.E., Lowe, N.K., "A critical review of Visual Analogue Scales in the measurement of clinical phenomena", Researchin Nursing & Health, 13(4), 227-236, 1990. https://doi:10.1002/nur.4770130405.
  • Yale University (2021), IM: Palliative Care [Online]. Available from: https://assessment-module.yale.edu/im-palliative/visual-analogue-scale.
  • Hobek, A.R., Mucuk, S., "Turkish women's opinions about cesarean delivery", Pak J Med Sci, 30(6), 1308-1313, 2014. https://doi:10.12669/pjms.306.5748.
  • Başar, F., Sağlam, H.Y., "Women’s choice of delivery methods and the factors that affect them", Journal of Current Researches on Health Sector, 8(1), 59-74, 2018.
  • Kısa, S., Kisa, A., Younis, M.Z., "Opinions and attitudes of obstetricians and midwives in Turkey towards caesarean section and vaginal birth following a previous caesarean section", Journal of International Medical Research, 45: 1739-1749. 2017. https://doi.org/10.1177/0300060516663998.
  • Appleton, B., Targett, C., Rasmussen, M., Readman, E., Sale, F., Permezel, M., "Knowledge and attitudes about vaginal birth after caesarean section in Australian hospitals", Aust N Z J Obstet Gynaecol, 40(2), 195-199, 2000.
Year 2022, Volume: 7 Issue: 3, 258 - 267, 25.12.2022
https://doi.org/10.33457/ijhsrp.1131379

Abstract

Project Number

None

References

  • Boerma, T., Ronsmans, C., Melesse, D.Y., Barros, A.J.D., Barros, F.C., Juan, L.,…&Temmerman, M., "Global epidemiology of use of and disparities in caesarean sections", Lancet, 13:392(10155), 1341-1348, 2018. https://doi:10.1016/S0140-6736(19)30698-1.
  • World Health Organization (2015). WHO Statement on caesarean section rates. [Online]. Available From: https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/.
  • Visser, G.H.A., Ayres-de-Campos, D., Barnea, E.R., Bernis, L., Renzo, G.C.D., Vidarte, M.F.E., … &Wallani, S., "FIGO position paper: how to stop the caesarean section epidemic", Lancet, 13:392(10155), 1286-1287, 2018. https://doi:10.1016/S0140-6736(18)32113-5.
  • Ye, J., Zhang, J., Mikolajczyk, R., Gülmezoğlu, A.M., Betran, A.P., "Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data", BJOG, 123(5),745-53, 2016. https://doi:10.1111/1471-0528.13592.
  • Cegolon, L., Mastrangelo, G., Maso, G., Dal Pozzo, G., Ronfani, L., Cegolon, A., "Understanding factors leading to primary cesarean section and vaginal birth after cesarean delivery in the Friuli- Venezia Giulia Region (North-Eastern Italy), 2005–2015". Sci Rep. 10(1),1-18, 2020. https://doi.org/10.1038/s41598-019-57037-y.
  • Montoya-Williams, D., Lemas, D.J., Spiryda, L., Patel, K., Neu, J., Carson, T.L., "What are optimal cesarean section rates in the U.S. and how do we get there? A review of evidence-based recommendations and interventions", J Women’s Health, 26(12), 1285-1291, 2017. https://doi:10.1089/jwh.2016.6188.
  • Liabsuetrakul, T., Sukmanee, J., Thungthong, J., Lumbiganon, P., "Trend of cesarean section rates and correlations with adverse maternal and neonatal outcomes: A secondary analysis of Thai universal coverage scheme data", AJP Rep, 9(4), 328–336, 2019. https://doi:10.1055/s-0039-1697656.
  • Molina, G., Weiser, T.G., Lipsitz, S.R., Esquivel, M.M., Uribe-Leitz, T., Azad, T., …& Haynes, A.B., "Relationship between cesarean delivery rate and maternal and neonatal mortality", JAMA, 314(21), 2263–2270, 2015. https://doi:10.1001/jama.2015.15553.
  • Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, …& Temmerman, M., "Short-term and long-term effects of caesarean section on the health of women and children", Lancet, 13;392 (10155), 1349-1357, 2018. https://doi:10.1016/S0140-6736(18)31930-5.
  • de Elejalde, R., Giolito, E., (2019). More hospital choices, more c-sections: Evidence from Chile. IZA Institute of Labor Economics Discussion Paper Series, No. 12297. [Online]. Available from: http://ftp.iza.org/dp12297.pdf.
  • American College of Obstetricians and Gynecologists., "ACOG Practice Bulletin No. 205: Vaginal birth after cesarean delivery", Obstetrics & Gynecology, 133(2), 110-127, 2019. https://doi:10.1097/AOG.0000000000003078.
  • Black. C., Kaye, J., Jick, H, "Cesarean delivery in the United Kingdom: time trends in the general practice research database", Obstet Gynecol, 106(1):151-155, 2005. https://doi:151–5.10.1097/01.AOG.0000160429.22836.
  • Landon, M.B., Hauth, J.C., Leveno, K.J., Spong, C.Y., Leindecker, S., Varner, M.W., …& Gabbe, S.G., "Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery", The New England Journal of Medicine. 2004; 351(25): 2581-2589.
  • Lundgren, I., van Limbeek, E., Vehvilainen-Julkunen, K., "Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): A qualitativestudy from countries with high VBAC rates", BMC Pregnancy and Childbirth, 15:196, 2015. https://doi:10.1186/s12884-015-0629-6.
  • Lundgren, I., Healy, P., Caroll, M., Begley, C., Matterne, A., Gross, M.M., …& Lalor, J., "Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): A study from countries with low VBAC rates", BMC Pregnancy and Childbirth, 16:350. 2016. https://doi:10.1186/s12884-016-1144-0.
  • Lundgren, I., Morano, S., Nillson, C., Sinclair, M., Begley, C., "Cultural perspectives on vaginal birth after previous caesarean section in countries with high and low rates — A hermeneutic study", Women and Birth, 33: 339–347, 2020. https://doi.org/10.1016/j.wombi.2019.07.300.
  • Davis, D., Homer, S.C., Clack, D., Turkmani, S., Foureur, M., "Choosing vaginal birth after caesarean section: Motivating factors", Midwifery, 88, 102766, 2020. https://doi.org/10.1016/j.midw.2020.102766.
  • Firoozi, M., Tara, F., Ahanchian, M., Roudsari, R.B., "Health care system barriers to vaginal birth after cesarean section: A qualitative study", Iranian Journal of Nursing and Midwifery Research, 25(3), 202-211, 2021. https://doi.org/10.4103/ijnmr.IJNMR_150_19.
  • Linn, G., Ying, Y., Chang, K., "The determinants of obstetricians’ willingness to undertake delivery by vaginal birth after cesarean section in Taiwan", Therapeutics and Clinical Risk Management, 15: 991–1002, 2019; https://doi.org/10.2147/TCRM.S205009.
  • Organisation for Economic Cooperation and Development (2018), Health care use - Caesarean sections- OECD Data. [Online]. Available from: https://data.oecd.org/healthcare/caesarean-sections.htm.
  • Republic of Türkiye Ministry of Health (2014), Birth and Cesarean Section Management Guide. [Online]. Available from: https://dosyamerkez.saglik.gov.tr/Eklenti/6407,dogum-ve-sezaryen-eylemi-yonetim-rehberipdf.pdf?
  • Hacettepe University (2018), Turkey Demographic and Health Survey. [Online]. Available from: http://www.hips.hacettepe.edu.tr/tnsa2018/rapor/TNSA2018_ana_Rapor.pdf.
  • Republic of Türkiye Ministry of Health (2018), Health Indicators of Turkey. [Online]. Available from: https://khgmozellikli.saglik.gov.tr/svg/inc/saglik_gostergeleri.pdf.
  • Uçar, T., Derya, Y.A., Barut, S., Güney, E., Sabancı, E., Unver, H., "Opinions of labor professionals about vaginal birth after cesarean in Turkey. International Journal of Caring Sciences, 11(2), 1043-49, 2018.
  • Ünsal, A.Ş., Kavalak, O., Dönmez, S., Öztürk, R., Güleç, D., Çelik, N., …& Weller, B.K., "Opinions and knowledge of healthcare professionals on vaginal birth after caesarean section", JACSD, 11: 119-133, 2017. https://doi:10.17367/JACSD.2017.3.4.
  • Wewers, M.E., Lowe, N.K., "A critical review of Visual Analogue Scales in the measurement of clinical phenomena", Researchin Nursing & Health, 13(4), 227-236, 1990. https://doi:10.1002/nur.4770130405.
  • Yale University (2021), IM: Palliative Care [Online]. Available from: https://assessment-module.yale.edu/im-palliative/visual-analogue-scale.
  • Hobek, A.R., Mucuk, S., "Turkish women's opinions about cesarean delivery", Pak J Med Sci, 30(6), 1308-1313, 2014. https://doi:10.12669/pjms.306.5748.
  • Başar, F., Sağlam, H.Y., "Women’s choice of delivery methods and the factors that affect them", Journal of Current Researches on Health Sector, 8(1), 59-74, 2018.
  • Kısa, S., Kisa, A., Younis, M.Z., "Opinions and attitudes of obstetricians and midwives in Turkey towards caesarean section and vaginal birth following a previous caesarean section", Journal of International Medical Research, 45: 1739-1749. 2017. https://doi.org/10.1177/0300060516663998.
  • Appleton, B., Targett, C., Rasmussen, M., Readman, E., Sale, F., Permezel, M., "Knowledge and attitudes about vaginal birth after caesarean section in Australian hospitals", Aust N Z J Obstet Gynaecol, 40(2), 195-199, 2000.
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Details

Primary Language English
Subjects Nursing
Journal Section Article
Authors

Rojjin Mamuk 0000-0003-3612-2010

Tuğba Yılmaz Esencan 0000-0002-8748-0793

Project Number None
Publication Date December 25, 2022
Submission Date June 15, 2022
Acceptance Date October 23, 2022
Published in Issue Year 2022 Volume: 7 Issue: 3

Cite

IEEE R. Mamuk and T. Yılmaz Esencan, “HEALTHCARE PROFESSIONALS’ ATTITUDES TOWARDS VAGINAL BIRTH AFTER CESAREAN SECTION; İSTANBUL EXAMPLE”, IJHSRP, vol. 7, no. 3, pp. 258–267, 2022, doi: 10.33457/ijhsrp.1131379.

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