Does continuity of care impact decision making in the next birth after a caesarean section (VBAC)? A randomised controlled trial

Caroline S E Homer, Karyn Besley, Jennifer Bell, Deborah DAVIS, Jon Adams, Alison Porteous, Maralyn Foureur

Research output: Contribution to journalArticle

6 Citations (Scopus)
5 Downloads (Pure)

Abstract

BACKGROUND:
Caesarean section (CS) has short and long-term health effects for both the woman and her baby. One of the greatest contributors to the CS rate is elective repeat CS. Vaginal birth after caesarean (VBAC) is an option for many women; despite this the proportion of women attempting VBAC remains low. Potentially the relationship that women have with their healthcare professional may have a major influence on the uptake of VBAC. Models of service delivery, which enable an individual approach to care, may make a difference to the uptake of VBAC. Midwifery continuity of care could be an effective model to encourage and support women to choose VBAC.
METHODS/DESIGN:
A randomised, controlled trial will be undertaken. Eligible pregnant women, whose most recent previous birth was by lower-segment CS, will be randomly allocated 1:1 to an intervention group or control group. The intervention provides midwifery continuity of care to women through pregnancy, labour, birth and early postnatal care. The control group will receive standard hospital care from different midwives through pregnancy, labour, birth and early postnatal care. Both groups will receive an obstetric consultation during pregnancy and at any other time if required. Clinical care will follow the same guidelines in both groups.
DISCUSSION:
This study will determine whether midwifery continuity of care influences the decision to attempt a VBAC and impacts on mode of birth, maternal experiences with care and the health of the neonate. Outcomes from this study might influence the way maternity care is provided to this group of women and thus impact on the CS rate. This information will provide high level evidence to policy makers, health service managers and practitioners who are working towards addressing the increased rate of CS.
TRIAL REGISTRATION:
This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12611001214921.
Original languageEnglish
Pages (from-to)140-145
Number of pages6
JournalBMC Pregnancy and Childbirth
Volume13
Issue number1
DOIs
Publication statusPublished - 2013

Fingerprint

Vaginal Birth after Cesarean
Continuity of Patient Care
Cesarean Section
Decision Making
Randomized Controlled Trials
Parturition
Midwifery
Postnatal Care
Pregnancy
Repeat Cesarean Section
Delivery of Health Care
Control Groups
Administrative Personnel
New Zealand
Obstetrics
Health Services
Registries
Pregnant Women
Referral and Consultation
Mothers

Cite this

Homer, Caroline S E ; Besley, Karyn ; Bell, Jennifer ; DAVIS, Deborah ; Adams, Jon ; Porteous, Alison ; Foureur, Maralyn. / Does continuity of care impact decision making in the next birth after a caesarean section (VBAC)? A randomised controlled trial. In: BMC Pregnancy and Childbirth. 2013 ; Vol. 13, No. 1. pp. 140-145.
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Does continuity of care impact decision making in the next birth after a caesarean section (VBAC)? A randomised controlled trial. / Homer, Caroline S E; Besley, Karyn; Bell, Jennifer; DAVIS, Deborah; Adams, Jon; Porteous, Alison; Foureur, Maralyn.

In: BMC Pregnancy and Childbirth, Vol. 13, No. 1, 2013, p. 140-145.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Does continuity of care impact decision making in the next birth after a caesarean section (VBAC)? A randomised controlled trial

AU - Homer, Caroline S E

AU - Besley, Karyn

AU - Bell, Jennifer

AU - DAVIS, Deborah

AU - Adams, Jon

AU - Porteous, Alison

AU - Foureur, Maralyn

PY - 2013

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N2 - BACKGROUND: Caesarean section (CS) has short and long-term health effects for both the woman and her baby. One of the greatest contributors to the CS rate is elective repeat CS. Vaginal birth after caesarean (VBAC) is an option for many women; despite this the proportion of women attempting VBAC remains low. Potentially the relationship that women have with their healthcare professional may have a major influence on the uptake of VBAC. Models of service delivery, which enable an individual approach to care, may make a difference to the uptake of VBAC. Midwifery continuity of care could be an effective model to encourage and support women to choose VBAC.METHODS/DESIGN:A randomised, controlled trial will be undertaken. Eligible pregnant women, whose most recent previous birth was by lower-segment CS, will be randomly allocated 1:1 to an intervention group or control group. The intervention provides midwifery continuity of care to women through pregnancy, labour, birth and early postnatal care. The control group will receive standard hospital care from different midwives through pregnancy, labour, birth and early postnatal care. Both groups will receive an obstetric consultation during pregnancy and at any other time if required. Clinical care will follow the same guidelines in both groups.DISCUSSION:This study will determine whether midwifery continuity of care influences the decision to attempt a VBAC and impacts on mode of birth, maternal experiences with care and the health of the neonate. Outcomes from this study might influence the way maternity care is provided to this group of women and thus impact on the CS rate. This information will provide high level evidence to policy makers, health service managers and practitioners who are working towards addressing the increased rate of CS.TRIAL REGISTRATION:This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12611001214921.

AB - BACKGROUND: Caesarean section (CS) has short and long-term health effects for both the woman and her baby. One of the greatest contributors to the CS rate is elective repeat CS. Vaginal birth after caesarean (VBAC) is an option for many women; despite this the proportion of women attempting VBAC remains low. Potentially the relationship that women have with their healthcare professional may have a major influence on the uptake of VBAC. Models of service delivery, which enable an individual approach to care, may make a difference to the uptake of VBAC. Midwifery continuity of care could be an effective model to encourage and support women to choose VBAC.METHODS/DESIGN:A randomised, controlled trial will be undertaken. Eligible pregnant women, whose most recent previous birth was by lower-segment CS, will be randomly allocated 1:1 to an intervention group or control group. The intervention provides midwifery continuity of care to women through pregnancy, labour, birth and early postnatal care. The control group will receive standard hospital care from different midwives through pregnancy, labour, birth and early postnatal care. Both groups will receive an obstetric consultation during pregnancy and at any other time if required. Clinical care will follow the same guidelines in both groups.DISCUSSION:This study will determine whether midwifery continuity of care influences the decision to attempt a VBAC and impacts on mode of birth, maternal experiences with care and the health of the neonate. Outcomes from this study might influence the way maternity care is provided to this group of women and thus impact on the CS rate. This information will provide high level evidence to policy makers, health service managers and practitioners who are working towards addressing the increased rate of CS.TRIAL REGISTRATION:This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12611001214921.

KW - Caesarean section

KW - Midwifery care

KW - Obstetrics

KW - Vaginal birth

KW - Vaginal birth after caesarean

U2 - 10.1186/1471-2393-13-140

DO - 10.1186/1471-2393-13-140

M3 - Article

VL - 13

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JO - BMC Pregnancy and Childbirth

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