Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees

Autores
Perrotta, Carla; Romero, Mariana; Sguassero, Yanina; Straw, Cecilia; Gialdini, Celina; Righetti, Natalia; Betran, Ana Pilar; Ramos, Silvina
Año de publicación
2022
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Objectives To explore obstetricians', midwives' and trainees' perceptions of caesarean section (CS) determinants in the context of public obstetric care services provision in Argentina. Our hypothesis is that known determinants of CS use may differ in settings with limited access to essential obstetric services. Setting We conducted a formative research study in 19 public maternity hospitals in Argentina. An institutional survey assessed the availability of essential obstetric services. Subsequently, we conducted online surveys and semistructured interviews to assess the opinions of providers on known CS determinants. Results Obstetric services showed an adequate provision of emergency obstetric care but limited services to support women during birth. Midwives, with some exceptions, are not involved during labour. We received 680 surveys from obstetricians, residents and midwives (response rate of 63%) and interviewed 26 key informants. Six out of 10 providers (411, 61%) indicated that the use of CS is associated with the complexities of our caseload. Limited pain management access was deemed a potential contributing factor for CS in adolescents and first-time mothers. Providers have conflicting views on the adequacy of training to deal with complex or prolonged labour. Obstetricians with more than 10 years of clinical experience indicated that fear of litigation was also associated with CS. Overall, there is consensus on the need to implement interventions to reduce unnecessary CS. Conclusions Public maternity hospitals in Argentina have made significant improvements in the provision of emergency services. The environment of service provision does not seem to facilitate the physiological process of vaginal birth. Providers acknowledged some of these challenges.
Fil: Perrotta, Carla. Universidad de Dublin; Irlanda
Fil: Romero, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Sguassero, Yanina. Centro Rosarino de Estudios Perinatales; Argentina
Fil: Straw, Cecilia. Universidad de Buenos Aires; Argentina
Fil: Gialdini, Celina. Centro Rosarino de Estudios Perinatales; Argentina
Fil: Righetti, Natalia. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Betran, Ana Pilar. Organizacion Mundial de la Salud; Argentina
Fil: Ramos, Silvina. Centro de Estudios de Estado y Sociedad; Argentina
Materia
MATERNAL MEDICINE
ORGANISATION OF HEALTH SERVICES
PUBLIC HEALTH
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/200226
Acceder
id CONICETDig_f609beb3b1958493fcbaa8038fafe477
oai_identifier_str oai:ri.conicet.gov.ar:11336/200226
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and traineesPerrotta, CarlaRomero, MarianaSguassero, YaninaStraw, CeciliaGialdini, CelinaRighetti, NataliaBetran, Ana PilarRamos, SilvinaMATERNAL MEDICINEORGANISATION OF HEALTH SERVICESPUBLIC HEALTHhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Objectives To explore obstetricians', midwives' and trainees' perceptions of caesarean section (CS) determinants in the context of public obstetric care services provision in Argentina. Our hypothesis is that known determinants of CS use may differ in settings with limited access to essential obstetric services. Setting We conducted a formative research study in 19 public maternity hospitals in Argentina. An institutional survey assessed the availability of essential obstetric services. Subsequently, we conducted online surveys and semistructured interviews to assess the opinions of providers on known CS determinants. Results Obstetric services showed an adequate provision of emergency obstetric care but limited services to support women during birth. Midwives, with some exceptions, are not involved during labour. We received 680 surveys from obstetricians, residents and midwives (response rate of 63%) and interviewed 26 key informants. Six out of 10 providers (411, 61%) indicated that the use of CS is associated with the complexities of our caseload. Limited pain management access was deemed a potential contributing factor for CS in adolescents and first-time mothers. Providers have conflicting views on the adequacy of training to deal with complex or prolonged labour. Obstetricians with more than 10 years of clinical experience indicated that fear of litigation was also associated with CS. Overall, there is consensus on the need to implement interventions to reduce unnecessary CS. Conclusions Public maternity hospitals in Argentina have made significant improvements in the provision of emergency services. The environment of service provision does not seem to facilitate the physiological process of vaginal birth. Providers acknowledged some of these challenges.Fil: Perrotta, Carla. Universidad de Dublin; IrlandaFil: Romero, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; ArgentinaFil: Sguassero, Yanina. Centro Rosarino de Estudios Perinatales; ArgentinaFil: Straw, Cecilia. Universidad de Buenos Aires; ArgentinaFil: Gialdini, Celina. Centro Rosarino de Estudios Perinatales; ArgentinaFil: Righetti, Natalia. Centro de Estudios de Estado y Sociedad; ArgentinaFil: Betran, Ana Pilar. Organizacion Mundial de la Salud; ArgentinaFil: Ramos, Silvina. Centro de Estudios de Estado y Sociedad; ArgentinaBMJ Publishing2022-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/200226Perrotta, Carla; Romero, Mariana; Sguassero, Yanina; Straw, Cecilia; Gialdini, Celina; et al.; Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees; BMJ Publishing; BMJ Open; 12; 1; 1-2022; 1-102044-6055CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1136/bmjopen-2021-053419info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-10-22T11:10:11Zoai:ri.conicet.gov.ar:11336/200226instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-10-22 11:10:11.98CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees
title Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees
spellingShingle Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees
Perrotta, Carla
MATERNAL MEDICINE
ORGANISATION OF HEALTH SERVICES
PUBLIC HEALTH
title_short Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees
title_full Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees
title_fullStr Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees
title_full_unstemmed Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees
title_sort Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees
dc.creator.none.fl_str_mv Perrotta, Carla
Romero, Mariana
Sguassero, Yanina
Straw, Cecilia
Gialdini, Celina
Righetti, Natalia
Betran, Ana Pilar
Ramos, Silvina
author Perrotta, Carla
author_facet Perrotta, Carla
Romero, Mariana
Sguassero, Yanina
Straw, Cecilia
Gialdini, Celina
Righetti, Natalia
Betran, Ana Pilar
Ramos, Silvina
author_role author
author2 Romero, Mariana
Sguassero, Yanina
Straw, Cecilia
Gialdini, Celina
Righetti, Natalia
Betran, Ana Pilar
Ramos, Silvina
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv MATERNAL MEDICINE
ORGANISATION OF HEALTH SERVICES
PUBLIC HEALTH
topic MATERNAL MEDICINE
ORGANISATION OF HEALTH SERVICES
PUBLIC HEALTH
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Objectives To explore obstetricians', midwives' and trainees' perceptions of caesarean section (CS) determinants in the context of public obstetric care services provision in Argentina. Our hypothesis is that known determinants of CS use may differ in settings with limited access to essential obstetric services. Setting We conducted a formative research study in 19 public maternity hospitals in Argentina. An institutional survey assessed the availability of essential obstetric services. Subsequently, we conducted online surveys and semistructured interviews to assess the opinions of providers on known CS determinants. Results Obstetric services showed an adequate provision of emergency obstetric care but limited services to support women during birth. Midwives, with some exceptions, are not involved during labour. We received 680 surveys from obstetricians, residents and midwives (response rate of 63%) and interviewed 26 key informants. Six out of 10 providers (411, 61%) indicated that the use of CS is associated with the complexities of our caseload. Limited pain management access was deemed a potential contributing factor for CS in adolescents and first-time mothers. Providers have conflicting views on the adequacy of training to deal with complex or prolonged labour. Obstetricians with more than 10 years of clinical experience indicated that fear of litigation was also associated with CS. Overall, there is consensus on the need to implement interventions to reduce unnecessary CS. Conclusions Public maternity hospitals in Argentina have made significant improvements in the provision of emergency services. The environment of service provision does not seem to facilitate the physiological process of vaginal birth. Providers acknowledged some of these challenges.
Fil: Perrotta, Carla. Universidad de Dublin; Irlanda
Fil: Romero, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Sguassero, Yanina. Centro Rosarino de Estudios Perinatales; Argentina
Fil: Straw, Cecilia. Universidad de Buenos Aires; Argentina
Fil: Gialdini, Celina. Centro Rosarino de Estudios Perinatales; Argentina
Fil: Righetti, Natalia. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Betran, Ana Pilar. Organizacion Mundial de la Salud; Argentina
Fil: Ramos, Silvina. Centro de Estudios de Estado y Sociedad; Argentina
description Objectives To explore obstetricians', midwives' and trainees' perceptions of caesarean section (CS) determinants in the context of public obstetric care services provision in Argentina. Our hypothesis is that known determinants of CS use may differ in settings with limited access to essential obstetric services. Setting We conducted a formative research study in 19 public maternity hospitals in Argentina. An institutional survey assessed the availability of essential obstetric services. Subsequently, we conducted online surveys and semistructured interviews to assess the opinions of providers on known CS determinants. Results Obstetric services showed an adequate provision of emergency obstetric care but limited services to support women during birth. Midwives, with some exceptions, are not involved during labour. We received 680 surveys from obstetricians, residents and midwives (response rate of 63%) and interviewed 26 key informants. Six out of 10 providers (411, 61%) indicated that the use of CS is associated with the complexities of our caseload. Limited pain management access was deemed a potential contributing factor for CS in adolescents and first-time mothers. Providers have conflicting views on the adequacy of training to deal with complex or prolonged labour. Obstetricians with more than 10 years of clinical experience indicated that fear of litigation was also associated with CS. Overall, there is consensus on the need to implement interventions to reduce unnecessary CS. Conclusions Public maternity hospitals in Argentina have made significant improvements in the provision of emergency services. The environment of service provision does not seem to facilitate the physiological process of vaginal birth. Providers acknowledged some of these challenges.
publishDate 2022
dc.date.none.fl_str_mv 2022-01
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/200226
Perrotta, Carla; Romero, Mariana; Sguassero, Yanina; Straw, Cecilia; Gialdini, Celina; et al.; Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees; BMJ Publishing; BMJ Open; 12; 1; 1-2022; 1-10
2044-6055
CONICET Digital
CONICET
url http://hdl.handle.net/11336/200226
identifier_str_mv Perrotta, Carla; Romero, Mariana; Sguassero, Yanina; Straw, Cecilia; Gialdini, Celina; et al.; Caesarean birth in public maternities in Argentina: A formative research study on the views of obstetricians, midwives and trainees; BMJ Publishing; BMJ Open; 12; 1; 1-2022; 1-10
2044-6055
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1136/bmjopen-2021-053419
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BMJ Publishing
publisher.none.fl_str_mv BMJ Publishing
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 12.982451

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