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Title: Improving the organisation of maternal health service delivery and optimising childbirth by increasing vaginal birth after caesarean section through enhanced women-centred care (OptiBIRTH trial) : study protocol for a randomised controlled trial (ISRCTN10612254)
Authors : Clarke, Mike
Savage, Gerard
Smith, Valerie
Daly, Deirdre
Devane, Declan
Gross, Mechthild Maria
Grylka, Susanne
Healy, Patricia
Morano, Sandra
Nicoletti, Jane
Begley, Cecily
Published in : Trials
Volume(Issue) : 16
Issue : 542
Publisher / Ed. Institution : BioMed Central
Issue Date: 30-Nov-2015
License (according to publishing contract) : CC BY 4.0: Namensnennung 4.0 International
Type of review: Open peer review
Language : English
Subjects : Clinical protocol; Cost saving; Cost-benefit analysis; Health care costs; Patient selection; Prospective studies; Research design; Treatment outcome; Delivery of health care; Maternal health services; Patient-centered care; Vaginal birth after cesarean
Subject (DDC) : 618: Gynecology, obstetrics and midwifery
Abstract: Background The proportion of pregnant women who have a caesarean section shows a wide variation across Europe, and concern exists that these proportions are increasing. Much of the increase in caesarean sections in recent years is due to a cascade effect in which a woman who has had one caesarean section is much more likely to have one again if she has another baby. In some places, it has become common practice for a woman who has had a caesarean section to have this procedure again as a matter of routine. The alternative, vaginal birth after caesarean (VBAC), which has been widely recommended, results in fewer undesired results or complications and is the preferred option for most women. However, VBAC rates in some countries are much lower than in other countries. Methods/Design The OptiBIRTH trial uses a cluster randomised design to test a specially developed approach to try to improve the VBAC rate. It will attempt to increase VBAC rates from 25 % to 40 % through increased women-centred care and women’s involvement in their care. Sixteen hospitals in Germany, Ireland and Italy agreed to join the study, and each hospital was randomly allocated to be either an intervention or a control site. Discussion If the OptiBIRTH intervention succeeds in increasing VBAC rates, its application across Europe might avoid the 160,000 unnecessary caesarean sections that occur every year at an extra direct annual cost of more than €150 million.
Further description : Open Access Journal
Departement: Gesundheit
Organisational Unit: Institute of Midwifery (IHB)
Publication type: Article in scientific Journal
DOI : 10.1186/s13063-015-1061-y
ISSN: 1745-6215
Appears in Collections:Publikationen Gesundheit

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