BMJ open · 2026
Attitudes of maternity care providers toward regional centralisation of vaginal breech birth: a qualitative study.
СтатьяНазвание и аннотация: Перевод в очереди
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Luiting-Wagenaar Danielle, van Dijk Merle, Ganzevoort Wessel, Moll Etelka, Scheele Fedde, Velzel Joost
Аннотация
OBJECTIVES: To explore maternity care providers' attitudes toward regional centralisation of vaginal breech birth (VBB) care and gather their recommendations for maintaining clinical proficiency.
DESIGN: Exploratory qualitative study using semi-structured interviews and thematic analysis.
PARTICIPANTS: 10 hospital-based maternity care professionals (nine obstetricians and one clinical midwife), purposively sampled to represent experience and institutional diversity.
SETTING: 10 hospital maternity units in a metropolitan region of the Netherlands.Key themes describing provider attitudes towards two proposed models of centralised care (mobile breech team, designated referral centre) and alternative strategies.
RESULTS: Three core themes emerged: (1) proficiency-providers valued regular exposure, formal training and peer support, expressing concern that centralisation would reduce overall workforce readiness; (2) organisation-concerns included unequal access, staffing burden, legal risks and inefficiencies in mobile teams and (3) alternatives-participants preferred a regional breech network with shared training, joint video review and expert on-call support.
CONCLUSIONS: Maternity care providers opposed full centralisation of VBB, favouring a networked model that distributes expertise and preserves local access. These insights highlight the importance of involving frontline providers in service redesign.
TRIAL REGISTRATION NUMBER: Not applicable.
DESIGN: Exploratory qualitative study using semi-structured interviews and thematic analysis.
PARTICIPANTS: 10 hospital-based maternity care professionals (nine obstetricians and one clinical midwife), purposively sampled to represent experience and institutional diversity.
SETTING: 10 hospital maternity units in a metropolitan region of the Netherlands.Key themes describing provider attitudes towards two proposed models of centralised care (mobile breech team, designated referral centre) and alternative strategies.
RESULTS: Three core themes emerged: (1) proficiency-providers valued regular exposure, formal training and peer support, expressing concern that centralisation would reduce overall workforce readiness; (2) organisation-concerns included unequal access, staffing burden, legal risks and inefficiencies in mobile teams and (3) alternatives-participants preferred a regional breech network with shared training, joint video review and expert on-call support.
CONCLUSIONS: Maternity care providers opposed full centralisation of VBB, favouring a networked model that distributes expertise and preserves local access. These insights highlight the importance of involving frontline providers in service redesign.
TRIAL REGISTRATION NUMBER: Not applicable.