OptiBIRTH: a cluster randomised trial of a complex intervention to increase vaginal birth after caesarean section.

Background: Despite evidence supporting the safety of vaginal birth after caesarean section (VBAC), rates are low in many countries.

Methods: OptiBIRTH investigated the effects of a woman-centred intervention designed to increase VBAC rates through an unblinded cluster randomised trial in 15 maternity units with VBAC rates < 35% in Germany, Ireland and Italy. Sites were matched in pairs or triplets based on annual birth numbers and VBAC rate, and randomised, 1:1 or 2:1, intervention versus control, following trial registration.

Factors influencing the clinical decision-making of midwives: a qualitative study.

Background: Although midwives make clinical decisions that have an impact on the health and well-being of mothers and babies, little is known about how they make those decisions. Wide variation in intrapartum decisions to refer women to obstetrician-led care suggests that midwives' decisions are based on more than the evidence based medicine (EBM) model - i.e.

The use of midwife-led primary antenatal care by obese women in The Netherlands: An explorative cohort study.

Objective: to study the effect of body mass index (BMI) on the use of antenatal care by women in midwife-led care.

Design: an explorative cohort study.

Setting: 11 Dutch midwife-led practices.

Responding to maternal distress: from needs assessment to effective intervention.

Objectives: To perform a needs assessment of maternal distress to plan the development of an intervention for the prevention and reduction of antenatal maternal distress.

Methods: We searched PubMed, OVID and EBSCO and applied the PRECEDE logic model to select the data. Experts in the field validated the findings.

The effect of gestational weight gain on likelihood of referral to obstetric care for women eligible for primary, midwife-led care after antenatal booking.

Objective: to examine the effect of gestational weight gain (GWG) on likelihood of referral from midwife-led to obstetrician-led care during pregnancy and childbirth for women in primary care at the outset of their pregnancy.

Design: secondary analysis of data from a prospective cohort study.

Setting: Dutch midwife-led practices.

Vaginal Birth After Cesarean: Views of Women From Countries With High VBAC Rates.

Despite the consequences for women's health, a repeat cesarean section (CS) birth after a previous CS is common in Western countries. Vaginal Birth After Cesarean (VBAC) is recommended for most women, yet VBAC rates are decreasing and vary across maternity organizations and countries. We investigated women's views on factors of importance for improving the rate of VBAC in countries where VBAC rates are high.

Clinicians' views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a qualitative study from countries with high VBAC rates.

Background: The most common reason for caesarean section (CS) is repeat CS following previous CS. Vaginal birth after caesarean section (VBAC) rates vary widely in different healthcare settings and countries. Obtaining deeper knowledge of clinicians' views on VBAC can help in understanding the factors of importance for increasing VBAC rates.

Women-centred interventions to increase vaginal birth after caesarean section (VBAC): A systematic review.

Objective: to evaluate the effectiveness of women-centred interventions during pregnancy and birth to increase rates of vaginal birth after caesarean.

Design: we searched bibliographic databases for randomised trials or cluster randomised trials on women-centred interventions during pregnancy and birth designed to increase VBAC rates in women with at least one previous caesarean section. Comparator groups included standard or usual care or an alternative treatment aimed at increasing VBAC rates.

Factors influencing maternal distress among Dutch women with a healthy pregnancy.

Background: Maternal distress is a public health concern. Assessment of emotional wellbeing is not integrated in Dutch antenatal care. Midwives need to understand the influencing factors in order to identify women who are more vulnerable to experience maternal distress.

Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): a systematic review.

Background: The number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives).

Patterns of gestational weight gain in healthy, low-risk pregnant women without co-morbidities.

Background: little is known of the impact of gestational weight gain (GWG) in relation to Body Mass Index (BMI) classification on perinatal outcomes in healthy pregnant women without co-morbidities. As a first step, the prevalence of obesity and the distribution of GWG in relation to the Institute of Medicine (IOM) 2009 guidelines for GWG were examined.

Methods: data from a prospective cohort study of - a priori - low risk, pregnant women from five midwife-led practices (n=1449) were analysed.