TY - JOUR
T1 - A research agenda to improve incidence and outcomes of assisted vaginal birth
AU - Betrán, Ana Pilar
AU - Torloni, Maria Regina
AU - Althabe, Fernando
AU - Altieri, Elena
AU - Arulkumaran, Sabaratnam
AU - Ashraf, Fatema
AU - Bailey, Patricia
AU - Bonet, Mercedes
AU - Bucagu, Maurice
AU - Clark, Emma
AU - Changizi, Nasrin
AU - Churchill, Robyn
AU - Dominico, Sunday
AU - Downe, Soo
AU - Draycott, Tim
AU - Faye, Arfang
AU - Feeley, Claire
AU - Geelhoed, Diederike
AU - Gherissi, Atf
AU - Gholbzouri, Karima
AU - Grupta, Gagan
AU - Hailegebriel, Tedbabe Degefie
AU - Hanson, Claudia
AU - Hartmann, Katharina
AU - Hassan, Lubna
AU - Hofmeyr, George Justus
AU - Jayathilaka, Anoma Chandani
AU - Kabore, Charles
AU - Kidula, Nancy
AU - Kingdon, Carol
AU - Kuzmenko, Oleg
AU - Lumbiganon, Pisake
AU - Mola, Glen D. L.
AU - Moran, Allisyn
AU - de Muncio, Bremen
AU - Nolens, Barbara
AU - Opiyo, Newton
AU - Pattinson, Robert C.
AU - Romero, Mariana
AU - van Roosmalen, Jos
AU - Siaulys, Monica M.
AU - Camelo, Jose Simon
AU - Smith, Jeffrey
AU - Sobel, Howard L.
AU - Sobhy, Soha
AU - Sosa, Claudio
AU - Souza, Joao Paulo
AU - Hoope-Bender, Petra Ten
AU - Thangaratinam, Shakila
AU - Varallo, John
AU - Wright, Alison
AU - Yates, Ann
AU - Oladapo, Olufemi O.
N1 - Publisher Copyright: © 2023, World Health Organization. All rights reserved.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal and childbirth outcomes. However, although the proportion of births by caesarean section has increased during the last few decades, the use of assisted vaginal birth has declined. This is particularly the case in low-and middle-income countries, despite an assisted vaginal birth often being less risky than caesarean birth. We therefore conducted a three-step process to identify a research agenda necessary to increase the use of, or reintroduce, assisted vaginal birth: after conducting an evidence synthesis, which informed a consultation with technical experts who proposed an initial research agenda, we sought and incorporated the views of women’s representatives of this agenda. This process has allowed us to identify a comprehensive research agenda, with topics categorized as: (i) the need to understand women’s perceptions of assisted vaginal birth, and provide appropriate and reliable information; (ii) the importance of training health-care providers in clinical skills but also in respectful care, effective communication, shared decision-making and informed consent; and (iii) the barriers to and facilitators of implementation and sustainability. From women’s feedback, we learned of the urgent need to recognize labour, childbirth and postpartum experiences as inherently physiological and dignified human processes, in which interventions should only be implemented if necessary. The promotion and/or reintroduction of assisted vaginal birth in low-resource settings requires governments, policy-makers and hospital administrators to support skilled health-care providers who can, in turn, respectfully support women in labour and childbirth.
AB - Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal and childbirth outcomes. However, although the proportion of births by caesarean section has increased during the last few decades, the use of assisted vaginal birth has declined. This is particularly the case in low-and middle-income countries, despite an assisted vaginal birth often being less risky than caesarean birth. We therefore conducted a three-step process to identify a research agenda necessary to increase the use of, or reintroduce, assisted vaginal birth: after conducting an evidence synthesis, which informed a consultation with technical experts who proposed an initial research agenda, we sought and incorporated the views of women’s representatives of this agenda. This process has allowed us to identify a comprehensive research agenda, with topics categorized as: (i) the need to understand women’s perceptions of assisted vaginal birth, and provide appropriate and reliable information; (ii) the importance of training health-care providers in clinical skills but also in respectful care, effective communication, shared decision-making and informed consent; and (iii) the barriers to and facilitators of implementation and sustainability. From women’s feedback, we learned of the urgent need to recognize labour, childbirth and postpartum experiences as inherently physiological and dignified human processes, in which interventions should only be implemented if necessary. The promotion and/or reintroduction of assisted vaginal birth in low-resource settings requires governments, policy-makers and hospital administrators to support skilled health-care providers who can, in turn, respectfully support women in labour and childbirth.
UR - http://www.scopus.com/inward/record.url?scp=85176882041&partnerID=8YFLogxK
U2 - https://doi.org/10.2471/BLT.23.290140
DO - https://doi.org/10.2471/BLT.23.290140
M3 - Article
C2 - 37961052
SN - 0042-9686
VL - 101
SP - 723
EP - 729
JO - Bulletin of the World Health Organization
JF - Bulletin of the World Health Organization
IS - 11
ER -