The acceptability to women of techniques for managing an impacted fetal head at caesarean section and of randomised trials evaluating those techniques: a qualitative study

Romano, Gabriella; Mitchell, Eleanor; Plachcinski, Rachel; Wakefield, Natalie; Walker, Kate; Ayers, Susan

Abstract

Background
This study aimed to explore women’s views on the acceptability of different techniques for managing an impacted fetal head at caesarean; and the feasibility and acceptability of conducting a trial in this area.

Methods
Qualitative semi-structured interviews with a systematic sample of women who experienced second stage emergency caesarean section at a tertiary National Health Service (NHS) hospital in England, UK. Thematic analysis was used to extract women’s views.

Results
Women varied in their perceptions of the acceptability of different techniques for managing impacted fetal head. Trust in medical expertise and prioritising the safety of the baby were important contextual factors. Greater consensus was found around informed choice in trials where subthemes considered the timing of invitation, reduced capacity to give consent in emergency situations, and the importance of birth outcomes and having good rapport with healthcare professionals who invite women into trials. Finally, women reflected on the importance of supportive antenatal and postpartum education for impacted fetal head.

Conclusions
This research provides information on the acceptability of techniques and any trial to evaluate these techniques. Findings illustrate the importance of context and quality of care to both acceptability and approaching women to take part in a future trial.

Citation

Romano, G., Mitchell, E., Plachcinski, R., Wakefield, N., Walker, K., & Ayers, S. (2021). The acceptability to women of techniques for managing an impacted fetal head at caesarean section and of randomised trials evaluating those techniques: a qualitative study. BMC Pregnancy and Childbirth, 21, Article 103. https://doi.org/10.1186/s12884-021-03577-z

• Journal Article Type: Article
• Acceptance Date: Jan 20, 2021
• Online Publication Date: Feb 2, 2021
• Publication Date: Feb 2, 2021
• Deposit Date: Feb 10, 2021
• Publicly Available Date: Feb 11, 2021
• Journal: BMC Pregnancy and Childbirth
• Electronic ISSN: 1471-2393
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Article Number: 103
• DOI: https://doi.org/10.1186/s12884-021-03577-z
• Keywords: Obstetrics and Gynaecology
• Public URL: https://nottingham-repository.worktribe.com/output/5314191
• Publisher URL: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03577-z