Midwives’ personal and professional attitudes towards women’s delivery choices, interventions and neonatal care

Ailbhe Duffy; Chloe Maculey; Stephen W. Lindow; Michael P. O’Connell

doi:10.1515/jpm-2022-0165

Article

Midwives’ personal and professional attitudes towards women’s delivery choices, interventions and neonatal care

Ailbhe Duffy , Chloe Maculey , Stephen W. Lindow and Michael P. O’Connell

Published/Copyright: September 13, 2022

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From the journal Journal of Perinatal Medicine Volume 51 Issue 3

Abstract

Objectives

Caesarean section (CS) rates in middle- and high-income countries are rising partly due to maternal request. This study aimed to explore the personal and professional attitudes of midwives and nurses towards women’s delivery choices, interventions and neonatal care.

Methods

Midwifery and nursing staff at the Coombe hospital were asked to complete a questionnaire concerning decisions for elective CS and neonatal care. The midwives’ responses were divided into multiparous and nulliparous according to their own parity.

Results

Multiparae and nulliparae did not differ on their personal preferences for their own baby. Only 3% wanted an elective CS in a normal, healthy pregnancy but this increased to 80.2% when there was a breech presentation and 42% if the estimated fetal weight was >4.5 kg. These numbers and trends were very close to the midwives’ professional recommendations under the same circumstances. The lower threshold for full resuscitation and ICU care was at 23 and 24 weeks gestation for both personal and professional recommendations. In the case of severely premature babies or babies with a poor prognosis, 54% stated that the approach to neonatal care was correct.

Conclusions

Overall, midwives’ professional views reflected what they would want for themselves and their babies. Only 3% recommended an elective CS in a normal, healthy pregnancy making it unlikely that midwives’ attitudes are driving the rise in CS rates in Ireland.

Keywords: attitudes; caesarean; choice; delivery; maternal request

Corresponding author: Ailbhe Duffy, Department of Obstetrics and Gynaecology, Coombe Women and Infants University Hospital, Cork Street, 8, Dublin, Ireland, E-mail: ailbheduffy@gmail.com

Acknowledgments

Coombe Women and Infants University Hospital for allowing this research to be conducted and all midwives who volunteered their time to participate in this study.

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The research related to human use has complied with all the relevant national regulations, institutional policies, and in accordance with the tenets of the Helsinki Declaration, and has been approved by the Authors’ Institutional Review Board or Equivalent Committee (AQUA).

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Received: 2022-03-26

Accepted: 2022-08-20

Published Online: 2022-09-13

Published in Print: 2023-03-28

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Articles in the same Issue

https://doi.org/10.1515/jpm-2022-0165

Keywords for this article

attitudes; caesarean; choice; delivery; maternal request