King's College London

Supporting women to have a normal birth: Field testing and pre-trial stage evaluation of a multi-media, interactive workshop package for maternity staff 2007-2010

Investigators: J Sandall*, N Leap, P Armstrong, S Bewley, N Edwards, C Warwick
Project Funding: DH Policy Research Programme.

Current maternity policy in England requires that all midwives and doctors should have up-to-date skills and knowledge to support women who wish to have a normal birth. The objectives of the study were to: Identify features of maternity practice and systems that may have a positive influence on women‘s experiences of coping with pain in labour; develop and field test an interactive multi-disciplinary learning package with staff in three NHS sites.

The learning package consisted of: on-line pre-and post-workshop questionnaire with a pre-workshop evidence briefing and post workshop feedback; 4-hour interactive, multi-media, interdisciplinary workshop; re-call session 6-8 weeks after the workshop involving a scenario based communication workstation (OSCE) followed by feedback. Field-testing of the four-hour workshop took place with midwives and medical staff in three NHS maternity services in inner city and semi-rural areas.

Participants in all sites were enthusiastic about the interdisciplinary, interactive nature of the workshop and the visual resources that were employed. It is important to note that the interactive workshop activities main focus was on developing confidence, and increasing self-efficacy, and there was a statistically significant increase in levels of knowledge of evidence, and self-efficacy. However, there were no significant differences regarding levels of staff knowledge of policy and attitudes towards normal birth. Higher levels of self-efficacy and a positive attitude to normal birth after the workshop were significantly correlated with higher performance scores in the OSCE. Having developed the package and the assessment tools, and established feasibility, the direct effect of the learning package on practice would need to be tested in a before and after randomised design.