Facilitators and barriers to external cephalic version for breech presentation at term among health care providers in the Netherlands: A quantitative analysis

Ageeth N. Rosman, Floortje Vlemmix, Antje Beuckens, Marlies E. Rijnders, Brent C. Opmeer, Ben Willem J Mol, Marjolein Kok, Margot A H Fleuren

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: guidelines recommend that external cephalic version (ECV) should be offered to all women with a fetus in breech presentation at term. However, only 50-60% of the women receive an ECV attempt. We explored the determinants (barriers and facilitators) affecting the uptake of the guidelines among gynaecologists and midwives in the Netherlands. Design: national online survey. Setting: the Netherlands. Participants: gynaecologists and midwives. Measurements: in the online survey, we identified the determinants that positively or negatively influenced the professionals[U+05F3] adherence to three key recommendations in the guidelines: (a) counselling, (b) advising for ECV, (c) arranging an ECV. Determinants were identified in a previously performed qualitative study and were categorised into five underlying constructs; attitude towards ECV, professional obligation, outcome expectations, self-efficacy and preconditions for successful ECV. We performed a multivariate analysis to assess the importance of the different constructs for adherence to the guideline. Findings: 364 professionals responded to the survey. Adherence varied: 84% counselled, 73% advised, and 82% arranged an ECV for (almost) all their clients. Although 90% of respondents considered ECV to be an effective treatment for preventing caesarean childbirths, only 30% agreed that 'every client should undergo ECV'. Self-efficacy (perceived skills) was the most important determinant influencing adherence. Key conclusions: self-efficacy appears to be the most significant determinant for counselling, advising and arranging an ECV. Implications for practice: to improve adherence to the guidelines on ECV we must improve self-efficacy.

Original languageEnglish
Pages (from-to)e145-e150
JournalMidwifery
Volume30
Issue number3
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Determinants
  • External cephalic version
  • Guidelines
  • Implementation

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Maternity and Midwifery

Cite this

Rosman, A. N., Vlemmix, F., Beuckens, A., Rijnders, M. E., Opmeer, B. C., Mol, B. W. J., ... Fleuren, M. A. H. (2014). Facilitators and barriers to external cephalic version for breech presentation at term among health care providers in the Netherlands: A quantitative analysis. Midwifery, 30(3), e145-e150. https://doi.org/10.1016/j.midw.2014.01.002