Gabriella Romano1, Eleanor Mitchell2, Rachel Plachcinski3, Natalie Wakefield2, Kate Walker4,5, Susan Ayers1. 1. Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK. 2. Nottingham Clinical Trials Unit, University of Nottingham, Building 42 University Park, Nottingham, NG7 2RD, UK. 3. National Childbirth Trust, NCT, 30 Euston Square, London, NW1 2FB, UK. 4. Nottingham Clinical Trials Unit, University of Nottingham, Building 42 University Park, Nottingham, NG7 2RD, UK. Kate.Walker@nottingham.ac.uk. 5. Division of Child Health, Obstetrics and Gynaecology, School of Medicine, Lenton, University of Nottingham, Nottingham, NG7 2RD, UK. Kate.Walker@nottingham.ac.uk.
Abstract
BACKGROUND: This study aimed to explore women's views on the acceptability of different techniques for managing an impacted fetal head at caesarean; and the feasibility and acceptability of conducting a trial in this area. METHODS: Qualitative semi-structured interviews with a systematic sample of women who experienced second stage emergency caesarean section at a tertiary National Health Service (NHS) hospital in England, UK. Thematic analysis was used to extract women's views. RESULTS: Women varied in their perceptions of the acceptability of different techniques for managing impacted fetal head. Trust in medical expertise and prioritising the safety of the baby were important contextual factors. Greater consensus was found around informed choice in trials where subthemes considered the timing of invitation, reduced capacity to give consent in emergency situations, and the importance of birth outcomes and having good rapport with healthcare professionals who invite women into trials. Finally, women reflected on the importance of supportive antenatal and postpartum education for impacted fetal head. CONCLUSIONS: This research provides information on the acceptability of techniques and any trial to evaluate these techniques. Findings illustrate the importance of context and quality of care to both acceptability and approaching women to take part in a future trial.
BACKGROUND: This study aimed to explore women's views on the acceptability of different techniques for managing an impacted fetal head at caesarean; and the feasibility and acceptability of conducting a trial in this area. METHODS: Qualitative semi-structured interviews with a systematic sample of women who experienced second stage emergency caesarean section at a tertiary National Health Service (NHS) hospital in England, UK. Thematic analysis was used to extract women's views. RESULTS:Women varied in their perceptions of the acceptability of different techniques for managing impacted fetal head. Trust in medical expertise and prioritising the safety of the baby were important contextual factors. Greater consensus was found around informed choice in trials where subthemes considered the timing of invitation, reduced capacity to give consent in emergency situations, and the importance of birth outcomes and having good rapport with healthcare professionals who invite women into trials. Finally, women reflected on the importance of supportive antenatal and postpartum education for impacted fetal head. CONCLUSIONS: This research provides information on the acceptability of techniques and any trial to evaluate these techniques. Findings illustrate the importance of context and quality of care to both acceptability and approaching women to take part in a future trial.
Entities:
Keywords:
Acceptability; Caesarean; Feasibility; Qualitative; Techniques for impacted fetal head
Authors: Edward M A Corry; Meenakshi Ramphul; Ann M Rowan; Ricardo Segurado; Rhona M Mahony; Declan P Keane Journal: Eur J Obstet Gynecol Reprod Biol Date: 2018-03-20 Impact factor: 2.435
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