Caesarean section rate reduced by a redesigned birthing room. Results of a quality improvement intervention at a hospital in Democratic Republic of Congo.

Autor: Berg M; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden; Faculty of Medicine and Community Health, Evangelical University in Africa, Bukavu, Democratic Republic of Congo; Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo. Electronic address: marie.berg@fhs.gu.se., Berg U; Faculty of Medicine and Community Health, Evangelical University in Africa, Bukavu, Democratic Republic of Congo; Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Mapatano E; Faculty of Medicine and Community Health, Evangelical University in Africa, Bukavu, Democratic Republic of Congo; Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo., Mukwege D; Faculty of Medicine and Community Health, Evangelical University in Africa, Bukavu, Democratic Republic of Congo; Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo.
Jazyk: angličtina
Zdroj: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives [Sex Reprod Healthc] 2024 Mar; Vol. 39, pp. 100925. Date of Electronic Publication: 2023 Nov 21.
DOI: 10.1016/j.srhc.2023.100925
Abstrakt: Objective: To evaluate the influence of a new birthing room at a tertiary hospital in eastern Democratic Republic of Congo (DRC), on the caesarean section (CS) rate in women classified as Robson group 1, i.e., nulliparous women at term with spontaneous onset of labour of one foetus in cephalic presentation.
Method: As part of quality improvement interventions, a new birthing room designed to promote person-centredness was constructed at the labour ward at Panzi General Referral Hospital in DRC. In a quasi-experimental study on women classified as Robson 1, a comparison was performed between the group being cared for in the new birthing room and the group being cared for in the general birthing room. The main outcome measure was CS rate.
Results: In the new person-centred birthing room, the CS rate was 17.1 % versus 28.4 % in women cared for in the general birthing room (p-value 0.001). There was also a higher presence of accompanying persons (p-value < 0.0001) and less use of synthetic oxytocin for the augmentation of labour (p-value 0.024). No difference in fear and childbirth experience was identified between women in the two rooms.
Conclusion: The results demonstrate that it is possible, in a low-income country as the Democratic Republic of Congo, to reduce the CS rate in women classified as Robson 1 by adapting the birthing environment to be more person-centred, without compromising other obstetric and neonatal outcomes.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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