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

BMC Pregnancy and Childbirth
Mike ClarkeCecily Begley

Abstract

Despite evidence supporting the safety of vaginal birth after caesarean section (VBAC), rates are low in many countries. 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. The intervention involved evidence-based education of clinicians and women with one previous caesarean section (CS), appointment of opinion leaders, audit/peer review, and joint discussions by women and clinicians. Control sites provided usual care. Primary outcome was annual hospital-level VBAC rates before the trial (2012) versus final year of the trial (2016). Between April 2014 and October 2015, 2002 women were recruited (intervention 1195, control 807), with mode-of-birth data available for 1940 women. The OptiBIRTH intervention was feasible and safe across hospital settings in three countries. There was no statistically significant difference in the change in the proportion of women having a VBAC between intervention s...Continue Reading

References

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Aug 26, 2019·Women and Birth : Journal of the Australian College of Midwives·Ingela LundgrenCecily Begley

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Citations

Jan 4, 2021·Sexual & Reproductive Healthcare : Official Journal of the Swedish Association of Midwives·Suniva PortzMechthild M Gross

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Clinical Trials Mentioned

ISRCTN10612254

Software Mentioned

lme4
OptiBIRTH
R

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