Clinicians' views of factors influencing decision-making for caesarean section: A systematic review and metasynthesis
Sunita Panda
Trinity College Dublin
Sunita Panda is a PhD student and HRB research fellow in School of Nursing and Midwifery, Trinity College Dublin. Following completion of her Masters in India, Sunita practised as a midwife in the Delivery Suite of Coombe Women and Infants University Hospital, Dublin, for over 11 years. With a successful award from Health Research Board, Sunita is currently undertaking her PhD studies under the expert supervision of Dr Deirdre Daly and Professor Cecily Begley. Sunita’s research study, ‘factors influencing decision-making for caesarean section’, is embedded in the MAMMI study (http://www.mammi.ie). As part of her research, Sunita has played an active role in the establishment of MAMMI study on a third site, the Coombe Women and Infants University Hospital, and has been involved in relevant clinical audits, supervision and teaching of midwifery students and dissemination of her ongoing research work through peer reviewed publications and presentations at national and international conferences.
Abstract
Background The rising caesarean section (CS) rate is a worldwide concern. According to midwives' and obstetricians' perspectives, the reasons for performing CS are complex, multifactorial and include both non-clinical and... [ view full abstract ]
Background
The rising caesarean section (CS) rate is a worldwide concern. According to midwives' and obstetricians' perspectives, the reasons for performing CS are complex, multifactorial and include both non-clinical and clinical factors.
Aim of review
To synthesise findings from studies that report clinicians' views on the factors that influence the decision to perform caesarean section.
Methods
A metasynthesis was conducted on findings from studies reporting clinicians' views on factors that influence the decision to perform CS. A total of 1451 studies were retrieved following a systematic search of five electronic databases: PubMed, CINAHL, PsycINFO, Maternity and Infant Care and Web of Science. Studies were selected following an independent review of title, abstract and full text by two reviewers. Methodological quality of included studies was assessed using EPPI-Centre’s 12 assessment criteria. Data were extracted from studies of medium and high quality, and thematically analysed.
Key findings
Forty-one studies spanning the years 1990 to 2015 and involving 13,143 clinicians (obstetricians, midwives and other professionals) from 22 countries were included. Clinicians’ perspectives on factors influencing the decision to perform CS were synthesised into five major themes; (1) clinical factors in decision-making for CS; (2) women’s anxiety and request for CS; (3) clinicians' personal preferences and practice patterns; (4) additional interventions and (5) external influences.
Conclusion and implications
To reduce the rising rate of CS it is vital to understand the complexities of the factors, both clinical and non-clinical, from the perspectives of decision-makers, the clinicians. This metasynthesis has identified the existence and influence of clinical and many non-clinical factors. This knowledge of avoidable factors that lead to CS will help midwives and obstetricians improve decision-making processes and clinical practice. Findings can be tested in later research to improve organisational regulation and policy to avoid unnecessary CS in future.
Authors
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Sunita Panda
(Trinity College Dublin)
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Deirdre Daly
(Trinity College Dublin)
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Cecily Begley
(Tri)
Topic Area
Topics: Maternity Care
Session
PPWT » Poster Presentations (Wed and Thurs) (13:30 - Wednesday, 9th November, Outside Dining Area)
Presentation Files
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