Journal of Women's Health Care
Open Access
ISSN: 2167-0420
ISSN: 2167-0420
A N (Ageeth) Rosman
Erasmus Medical Center, Netherlands
Posters & Accepted Abstracts: J Womens Health Care
Guidelines recommend that external cephalic version (ECV) should be offered to all eligible women with a fetus in breech presentation at term. However, only 70% of those women are offered an ECV attempt and only 50-60% of them recieve an ECV attempt. We explored the determinants (barriers and facilitators) affecting the uptake of the guidelines among gynecologists and midwives in the Netherlands. We held a national online survey among gynecologists and midwives in the Netherlands. In the online survey we identified the determinants that positively or negatively influenced the professionals adherence to three key recommendations in the guidelines: counselling; advising for ECV; 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; preconditions for successful ECV. We perfomed a multivariate analysis to assess the importance of the different constructs for adherence to the guideline. 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 the respondents considered ECV to be an effective treatment for preventing caesarean childbirths and only 30% agreed that every client should undergo ECV. Self-efficacy (perceived skills) was the most important determinant influencing adherence. Self-efficacy appears to be the most significant determinant for counselling, advising and arranging ECV. To improve adherence to the guidelines on ECV we must improve self-efficacy.
AN Rosman has completed her graduation as a Midwife in 1987. Till 2000, she practiced midwifery in a private primary practice in Zwolle (The Netherlands). Thereafter, she started working as a Midwife in secondary and tertiary care and started her PhD in 2009 on External Cephalic Version which she succesfully completed in 2014. Presently, she is working at the University of Rotterdam (Erasmus MC) as Senior Researcher and Project Manager of pre and interconception care, work related risks and pregnancy.