Increasing Staff Knowledge and Intent to Implement Physiological Birthing Positions

Abstract

Purpose. The purpose of this quality improvement (QI) project is to increase knowledge of physiological labor positions and intent to utilize various birthing positions among labor and delivery (L&D) staff through education at level II hospital in Gilbert, AZ.Background. Labor and birth are heavily influenced by many factors, including fetal status, maternal anatomy, placental sufficiency, contractions, the mother’s psyche, and maternal positioning (King et al., 2018). Primary cesarean sections (c-sections) are becoming more prevalent in United States (US), which raises concern among healthcare professionals with associated risks and complications (Lagrew et al., 2018). C-section births are associated with preventable maternal morbidity and mortality (Lagrew et al., 2018). Maternal morbidity rates are rising in US and more than double compared to other nations (e.g., Canada, France), actions must be taken to decrease unnecessary cesarean births (Tikkanen et al., 2020). Methods. This QI project adapted positions from Spinning Babies and Bundle Birth approaches implemented in local labor and delivery unit in Gilbert, AZ. New reference guides for labor and birthing positions were implemented in unit. Two in-person sessions led by principal investigator were completed with education on physiological birthing positions using Spinning Babies research. Participants involved in project were labor and delivery (L&D) nurses. Pre- and post-anonymous surveys were conducted at in-person sessions and evaluated participants’ knowledge, comfort, and intent to use information presented. Results. Results supported goal of project to increase knowledge and intent of labor and delivery nurses using various birthing positions. There was a total of 16 participants in two in-person education sessions held. Pre- and post-survey responses were collected from labor and delivery staff who attended sessions, evaluating their opinions and current understanding of physiological birth. Data from responses of pre- and post-surveys were analyzed using descriptive statistics. Data collected was formulated using tables and bar charts found in results section. Based on participants’ pre- and post-surveys, results showed increase in staff knowledge and intent when comparing survey questions and mean scores calculated. Primary c-section data was initially analyzed to determine intervention’s short-term effects, rates did decrease in post-implementation months, but is unclear if due to intervention. Conclusions. QI project addressed ongoing maternal morbidity and mortality rates seen from cesarean section complications. Project met objective of increasing awareness of physiological birth positions among labor and delivery staff in local hospitals.