Factors influencing midwives' use of an evidenced based Normal Birth Guideline.

Problem or issue: Rates of elective and unplanned caesarean section continue to increase in high income countries. Evidence-based clinical guidelines aim to promote and support normal birth but are rarely evaluated. What is already known: The Queensland Normal Birth Guideline was developed in consultation with stakeholders and disseminated to public and private hospitals and released in 2012. Impact of the Guideline on practice has not been investigated. What this paper adds: Although most midwives (90%) were aware of the guideline, only 71% reported that it routinely guided practice.