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Factors Affecting Confidence and Competence of Doctors in performing Operative Vaginal Births: a Qualitative study.
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  • Zainab Ashraf,
  • Lauren Crone,
  • Fionnuala McAuliffe,
  • Mary Higgins
Zainab Ashraf
National Maternity Hospital
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Lauren Crone
UCD College of Human Sciences
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Fionnuala McAuliffe
UCD Perinatal Research Centre
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Mary Higgins
University College Dublin
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Design: Qualitative research Setting: Two University Hospitals and one District Hospital in Ireland Population: Participants interviewed ranged from first year trainees to consultant obstetricians. Methods: Interviews using open ended questions. Interviews were recorded on audio and later transcribed. Main outcome measures: Thematic analysis was performed until saturation. Results: 35 obstetricians were interviewed. The median number of years of experience was 5 years (range 3-20 years). The median number of OVD was 200 (range 20-1000+). Vacuum was the preferred choice amongst junior trainees. Preference shifted to forceps with increasing clinical experience. Seven clear themes emerged. Three themes were common to all participants: firstly, that all clinicians reported respect for the primiparous OVD in anticipation of possible complications, secondly the wish for senior midwifery support and finally the importance of clinical experience and exposure. Four themes were common to trainees only. Female clinicians in training reported significant self-doubt in their ability to perform an OVD and had concerns about causing harm. Clinicians in training wished to be trained by consultants during their first year on the labour ward. Experience was important. The final theme was a wish for more training in forceps OVD by clinicians in training. Conclusion: This qualitative study identified factors that can be used to design education and training in OVD in order to improve care for the woman and baby.