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)

Mike Clarke, Gerard Savage, Valerie Smith, Deirdre Daly, Declan Devane, Mechthild M Gross, Susanne Grylka-Baeschlin, Patricia Healy, Sandra Morano, Jane Nicoletti, Cecily Begley

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)
177 Downloads (Pure)

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.

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

Original languageEnglish
Article number542
Number of pages9
JournalTrials
Volume16
DOIs
Publication statusPublished - 30 Nov 2015

Keywords

  • Clinical Protocols
  • Cost Savings
  • Cost-Benefit Analysis
  • Delivery of Health Care
  • Europe
  • Female
  • Health Care Costs
  • Humans
  • Maternal Health Services
  • Patient Selection
  • Patient-Centered Care
  • Pregnancy
  • Prospective Studies
  • Research Design
  • Treatment Outcome
  • Vaginal Birth after Cesarean
  • Journal Article
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

Fingerprint Dive into the research topics of '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)'. Together they form a unique fingerprint.

Cite this