Nurse attitudes toward childbirth: a concept clarification

To clarify the concept of "nurse attitudes toward childbirth."

It has been suggested that the international trend of escalating cesarean birth rates can be attributed to attitudes that perceive childbirth as an illness. Nurses' attitudes about childbirth direct their nursing care and may influence patient outcomes like cesarean birth. However, the concept "nurse attitudes toward childbirth" must be clarified to inform future research.

An English-language literature review, from 1990 to present, was performed using CINAHL, PubMed, and Ovid.

Norris's model of concept clarification was used.

Although the nursing literature poorly defined "nurse attitudes" and rarely used a conceptual framework, the discipline of psychology has been refining this concept for over 40 years. Psychologists have established that attitude can predict behavior as demonstrated through testing of the theory of planned behavior. Various types of "nurse attitudes toward childbirth" were identified through our literature review, and five central beliefs were noted. This resulted in the development of a preliminary model using theory of planned behavior as a foundation. Finally, potential research hypotheses were generated.

This paper clarifies "nurse attitudes toward childbirth" and supports its use for research. Nurse scholars have demonstrated that labor and delivery nurses do have individual attitudes toward childbirth, and the measurement of these attitudes may predict nursing care intentions and behavior. This concept is appropriate, important, and may be used as a means of exploring relationships between nursing care and the rising primary cesarean birth rate.