Practice variation in induction of labor: A critical document analysis on the contribution of regional protocols.

Rationale: Despite national guidelines with recommendations on induction of labor (IOL), large variation in the use of this intervention exists between regions in the Netherlands. Guidelines are translated into protocols, which give a contextual description of medical practice provided in a given region. Possibly, protocols developed by regional multidisciplinary maternity care networks (MCNs) contribute to the regional variation in IOL.

Validation of the Birth Beliefs Scale for maternity care professionals in The Netherlands.

Objectives: To validate the Birth Beliefs Scale (BBS) for maternity care professionals by testing: (1) content validity; (2) internal reliability; (3) known-group discriminant validity; and examine potential relationships between regions and birth beliefs.

Methods: First, content validity was tested. Before distribution of the questionnaire among maternity care professionals of six maternity care networks (MCNs), adjustments in the statements were made whenever content validity was too low.

Knowledge and skills used for clinical decision-making on childbirth interventions: A qualitative study among midwives in the Netherlands.

Introduction: Appropriate use of interventions in maternity care is a worldwide issue. Midwifery-led models of care are associated with more efficient use of resources, fewer medical interventions, and improved outcomes. However, the use of interventions varies considerably between midwives.

Regional variations in childbirth interventions and their correlations with adverse outcomes, birthplace and care provider: A nationwide explorative study.

Background: Variations in childbirth interventions may indicate inappropriate use. Most variation studies are limited by the lack of adjustments for maternal characteristics and do not investigate variations in adverse outcomes. This study aims to explore regional variations in the Netherlands and their correlations with referral rates, birthplace, interventions, and adverse outcomes, adjusted for maternal characteristics.

The dynamics of epidural and opioid analgesia during labour.

Purpose: To investigate the association of analgesia, opioids or epidural, or the combination of both with labour duration and spontaneous birth in nulliparous women.

Methods: A secondary data analysis of an existing cohort study was performed and included nulliparous women (n = 2074). Durations of total labour and first and second labour stage were calculated with Kaplan-Meier estimation for the four different study groups: no analgesia (n = 620), opioid analgesia (n = 743), epidural analgesia (n = 482), and combined application (n = 229).