Work Experience and Attitudes About Birth in Relation to Nurses' Cesarean Rates for Women With Low-Risk Pregnancies

To examine the relationships among years of experience and attitudes about birth among labor and delivery nurses and their individual cesarean rates for women with low-risk pregnancies.

Non-experimental correlational study.

One large academic medical center in the northeastern United States.

Labor and delivery nurses (N = 68).

We collected data through a one-time online survey that included a demographic questionnaire and the Nurse Attitudes and Beliefs Questionnaire-Revised. We measured years of overall registered nursing experience, labor and delivery experience, and experience on the unit and calculated cesarean rates using data from retrospective chart reviews of women with low-risk pregnancies (nulliparous, term, singleton, vertex; NTSV) whose births were attended by participants. We used descriptive statistics and chi-square tests with calculated odds ratios and confidence intervals for the analyses and compared rates above and below the median threshold.

Nurse cesarean rates for women with NTSV pregnancies ranged from 2% to 46%. Nurses with more years of work experience as registered nurses, in labor and delivery, and on their current units had greater odds of lower cesarean rates (≤24%) than those with less work experience. In addition, participants who worked the day shift, served as charge nurses, or held part-time or per-diem positions had greater odds of lower cesarean rates (≤24%) than those who worked the night shift, were not in charge nurse roles, or worked full-time. We found no significant correlation between attitudes about birth and nurse cesarean rates.

Our results suggest that increased years of nursing experience could be correlated with lower cesarean rates for women with low-risk pregnancies. Further research with larger samples is warranted to better understand the effect of nursing experience and to explore additional contributing factors.