Attitudes towards mode of birth among Swedish midwives

Abstract

Objective: to investigate midwives' attitudes and opinions on mode of birth.

Design: exploratory descriptive study. Data were collected via study-specific questionnaires during 2006.

Setting: southeastern Sweden.

Participants: all midwives working in two counties.

Findings: regardless of age, experience and working field, the midwives considered a reasonable caesarean rate to be around 11.5 per cent. None of the participants thought that the caesarean rate was too low. Midwives younger than 50 years tended to consider the current caesarean rate to be too high (p=0.059). Midwives working on labour wards stated that they thought the current caesarean rate was too high compared with midwives working at antenatal care clinics (ACCs) (p<0.001). Midwives working at ACCs agreed with the statements 'one should agree to a woman's right to have an elective caesarean' (p<0.001) and 'elective caesarean is the best choice for a woman with fear of birth' (p=0.046) more often than midwives working on labour wards, regardless of age or working experience.

Key conclusions and implications for practice: midwives working at ACCs are more willing to accept caesarean section at the woman's request and for women with fear of birth. It is of importance that ACC caregivers and professionals on labour wards increase their collaboration and have continuous discussions with one another in an attempt to reach consensus about the appropriate caesarean rates on evidence-based grounds.