Tools
Tools
Dasgupta, T, Hunter, S, Reid, S, Sandall, J, Shennan, A, Davies, SM and Walker, S (2022) Breech specialist midwives and clinics in the OptiBreech Trial feasibility study: An implementation process evaluation. Birth. ISSN 0730-7659
|
Text
Birth - 2022 - Dasgupta - Breech specialist midwives and clinics in the OptiBreech Trial feasibility study An.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
Background: Attendance of skilled and experienced professionals at breech births has been associated with a reduction in adverse perinatal outcomes. We aimed to determine whether United Kingdom National Health Service (NHS) sites could reliably provide attendants with OptiBreech training and/or advanced proficiency (intervention feasibility) and consistent care (fidelity) that meets women's needs (acceptability), with low neonatal admission rates (safety) and recruitment adequate to support a clinical trial (trial feasibility).
Methods: Mixed methods implementation evaluation was used. Settings were 13 services in England and Wales. Participants were 82 women requesting support for a vaginal breech birth (VBB) at term. Outcomes were descriptively analyzed. Twenty-one women were interviewed, and transcripts were analyzed using the Theoretical Framework of Acceptability. Iterative analysis informed subsequent interviews and the ongoing process of implementation across sites.
Results: Although we initially suggested multidisciplinary teams, actively recruiting Trusts yielded services where VBB care was provided through a dedicated clinic, organized and delivered primarily by a lead midwife who functioned as a specialist. This model achieved 87.5% fidelity with the intervention's goal of ensuring the attendance of OptiBreech-trained professionals. Neonatal outcomes remained stable, with an admission rate of 5.5%. Women reported care from specialist midwives as highly acceptable, but the model is vulnerable without a strategic effort to develop additional proficient team members.
Conclusions: Dedicated clinics coordinated by specialist midwives appear to be an acceptable and feasible implementation strategy to test the safety and effectiveness of proficient team care for VBB in a clinical trial. Back-up arrangements should be maintained while additional members of the team develop proficiency.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | breech clinics; breech presentation; breech teams; feasibility; implementation; specialist midwives; vaginal breech delivery; Obstetrics & Reproductive Medicine; 11 Medical and Health Sciences |
| Subjects: | R Medicine > RG Gynecology and obstetrics |
| Divisions: | Psychology (from Sep 2019) |
| Publisher: | Wiley |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 16 Nov 2022 11:52 |
| Last Modified: | 16 Nov 2022 12:00 |
| DOI or ID number: | 10.1111/birt.12685 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/18116 |
 |
View Item |