Maternal and child health journal · 2025
Integrating Obstetricians into Childbirth Education and Its Association with Reduced Intrapartum Interventions.
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Selman H Şule, Selman Saliha B, Çoker Hakan, Karabekir Neşe
Аннотация
BACKGROUND: Global concern about unwarranted childbirth interventions has intensified, with calls for respectful, evidence-based intrapartum care that supports physiologic birth. While antenatal education for expectant parents is common, the impact of multidisciplinary childbirth education for obstetricians has been underexplored.
METHODS: In a study of obstetricians (N = 112, Mage = 44.1 years, SD = 6.8, 57% female), those completing the Istanbul Birth Academy's Childbirth Educator and Doula Training (CEDT) program (n = 67) were compared with obstetricians without such training (n = 45) via a survey. Group differences were tested with independent-samples t test (Bonferroni-adjusted) and ANCOVA controlling for age, academic title, experience, low-risk caseload, and employer.
RESULTS: Of 31 practices, 26 differed by t test; 19 remained significant after correction. In adjusted models, 21 practices differed. CEDT-trained clinicians reported lower routine enemas, frequent digital exams, continuous CTG, routine IV lines, and IV fluids to shorten labor, with greater oral intake and nonpharmacologic pain relief; they more often supported instinctive pushing, upright positions, and delayed cord clamping, and less often used lithotomy and routine neonatal suctioning. Primary cesarean in nulliparas was lower.
CONCLUSION: This study's significance is that multidisciplinary childbirth educator-doula training for obstetricians is associated with fewer routine interventions and lower nulliparous primary cesarean rates. Prospective studies are warranted.
METHODS: In a study of obstetricians (N = 112, Mage = 44.1 years, SD = 6.8, 57% female), those completing the Istanbul Birth Academy's Childbirth Educator and Doula Training (CEDT) program (n = 67) were compared with obstetricians without such training (n = 45) via a survey. Group differences were tested with independent-samples t test (Bonferroni-adjusted) and ANCOVA controlling for age, academic title, experience, low-risk caseload, and employer.
RESULTS: Of 31 practices, 26 differed by t test; 19 remained significant after correction. In adjusted models, 21 practices differed. CEDT-trained clinicians reported lower routine enemas, frequent digital exams, continuous CTG, routine IV lines, and IV fluids to shorten labor, with greater oral intake and nonpharmacologic pain relief; they more often supported instinctive pushing, upright positions, and delayed cord clamping, and less often used lithotomy and routine neonatal suctioning. Primary cesarean in nulliparas was lower.
CONCLUSION: This study's significance is that multidisciplinary childbirth educator-doula training for obstetricians is associated with fewer routine interventions and lower nulliparous primary cesarean rates. Prospective studies are warranted.