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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)

GND
1152277189
ORCID
0000-0003-3020-3661
Affiliation
Northern Ireland Network for Trials Methodology Research, Centre for Public Health, Institute of Clinical Sciences B, Queen´s University Belfast, Royal Hospital
Clarke, Mike;
Affiliation
Centre for Public Health, Queens University Belfast
Savage, Gerard;
GND
1262433517
ORCID
0000-0003-2249-6038
Affiliation
School of Nursing and Midwifery; NUI Galway, School of Nursing and Midwifery, Trinity College Dublin
Smith, Valérie;
ORCID
0000-0003-3045-9894
Affiliation
School of Nursing and Midwifery, Trinity College Dublin
Daly, Deirdre;
ORCID
0000-0002-9393-7075
Affiliation
School of Nursing and Midwifery; NUI Galway,
Devane, Declan;
GND
123346924
ORCID
0000-0001-6348-0054
Affiliation
Medizinische Hochschule Hannover, Forschungs- und Lehreinheit Hebammenwissenschaft
Groß, Mechthild;
GND
1152273736
ORCID
0000-0001-5652-6886
Affiliation
Medizinische Hochschule Hannover, Forschungs- und Lehreinheit Hebammenwissenschaft
Grylka-Bäschlin, Susanne;
GND
140694978
ORCID
0000-0003-0865-7050
Affiliation
School of Nursing and Midwifery, NUI Galway
Healy, Patricia;
ORCID
0000-0002-2690-1347
Affiliation
Medical School and Midwifery School,Genoa University
Morano, Sandra;
Affiliation
Medical School and Midwifery School,Genoa University
Nicoletti, Jane;
ORCID
0000-0003-2240-8763
Affiliation
School of Nursing and Midwifery, Trinity College Dublin
Begley, Cecily

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 euro150 million. TRIAL REGISTRATION: Current Controlled Trials ISRCTN10612254 , registered 3 April 2013

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