Implementation of evidence-based practices in normal delivery care

Area of Science:

• Obstetrics and Gynecology
• Evidence-Based Medicine
• Maternal Health

Background:

• Normal delivery care practices can significantly impact maternal and neonatal outcomes.
• Implementing evidence-based practices (EBPs) is crucial for optimizing obstetric care.
• Gaps often exist between recommended EBPs and routine clinical practice in maternity settings.

Purpose of the Study:

• To evaluate the impact of an educational intervention designed to implement evidence-based practices in normal delivery care.
• To assess changes in normal delivery rates and specific care interventions following the educational program.

Main Methods:

• A quasi-experimental, before-and-after intervention study was conducted in a public maternity hospital.
• The study involved three phases: baseline audit, educational intervention, and post-intervention audit.
• Data were collected through interviews with 42 professionals and 280 women, and analysis of 555 medical records.

Main Results:

• The normal delivery rate increased by 5.3 percentage points post-intervention.
• Significant improvements included increased companion presence during labor (10.0 p.p.) and adoption of upright/squatting positions (31.4 p.p.).
• Reductions were observed in amniotomy (16.8 p.p.), lithotomy position (24.3 p.p.), and intravenous oxytocin use (17.1 p.p.).

Conclusions:

• The educational intervention positively impacted parturition assistance, leading to improved normal delivery care.
• While beneficial, the implementation process did not fully succeed in integrating all scientific evidence into normal delivery care at the institution.
• Further efforts are needed to ensure complete adoption of EBPs in normal childbirth settings.