Back to normal: A retrospective, cross-sectional study of the multi-factorial determinants of normal birth in Queensland, Australia

Miller, Yvette D, Prosser, Samantha J and Thompson, Rachel (2015) Back to normal: A retrospective, cross-sectional study of the multi-factorial determinants of normal birth in Queensland, Australia. Midwifery, 31 8: 818-827. doi:10.1016/j.midw.2015.04.005


Author Miller, Yvette D
Prosser, Samantha J
Thompson, Rachel
Title Back to normal: A retrospective, cross-sectional study of the multi-factorial determinants of normal birth in Queensland, Australia
Journal name Midwifery   Check publisher's open access policy
ISSN 0266-6138
1532-3099
Publication date 2015-08
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.midw.2015.04.005
Volume 31
Issue 8
Start page 818
End page 827
Total pages 10
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Collection year 2016
Language eng
Subject 2729 Obstetrics and Gynaecology
2913 Maternity and Midwifery
Formatted abstract
Background

Currently, care providers and policy-makers internationally are working to promote normal birth. In Australia, such initiatives are being implemented without any evidence of the prevalence or determinants of normal birth as a multidimensional construct. This study aimed to better understand the determinants of normal birth (defined as without induction of labour, epidural/spinal/general anaesthesia, forceps/vacuum, caesarean birth, or episiotomy) using secondary analyses of data from a population survey of women in Queensland, Australia.

Methods

Women who birthed in Queensland during a two-week period in 2009 were mailed a survey approximately three months after birth. Women (n=772) provided retrospective data on their pregnancy, labour and birth preferences and experiences, socio-demographic characteristics, and reproductive history. A series of logistic regressions were conducted to determine factors associated with having labour, having a vaginal birth, and having a normal birth.

Findings

Overall, 81.9% of women had labour, 66.4% had a vaginal birth, and 29.6% had a normal birth. After adjusting for other significant factors, women had significantly higher odds of having labour if they birthed in a public hospital and had a pre-existing preference for a vaginal birth. Of women who had labour, 80.8% had a vaginal birth. Women who had labour had significantly higher odds of having a vaginal birth if they attended antenatal classes, did not have continuous fetal monitoring, felt able to ‘take their time’ in labour, and had a pre-existing preference for a vaginal birth. Of women who had a vaginal birth, 44.7% had a normal birth. Women who had a vaginal birth had significantly higher odds of having a normal birth if they birthed in a public hospital, birthed outside regular business hours, had mobility in labour, did not have continuous fetal monitoring, and were non-supine during birth.

Conclusions

These findings provide a strong foundation on which to base resources aimed at increasing informed decision-making for maternity care consumers, providers, and policy-makers alike. Research to evaluate the impact of modifying key clinical practices (e.g., supporting women׳s mobility during labour, facilitating non-supine positioning during birth) on the likelihood of a normal birth is an important next step.
Keyword Childbirth
Normal birth
Caesarean section
Patient-reported data
Informed decision-making
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Psychology Publications
 
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