Exploring stakeholder's perception about factors affecting on implementation of physiologic birth plan: A qualitative approach

Abstract

Context: Following the increase in cesarean section rate in Iran, the Ministry of Health and Medical Education has planned a program for the promotion of normal birth. The plan named as “physiologic birth” that is equal with “spontaneous labor.” Aims: This study aims to explain factors affecting the implementation of “physiologic birth plan from stakeholders” view. Setting and Design: In this qualitative study, purposive samples of 21 health-care stakeholders (2 men and 19 women) were interviewed in 2016. The participants included three obstetricians and gynecologists, six midwives, three managers and experts in charge of the plan at the Mazandaran University of Medical Science, and nine women who gave birth under the physiological delivery (Spontaneous Labor) plan. Materials and Methods: Face-to-face semi-structured interviews and one focus group discussion were employed to collect the study data. Statistical Analysis Used: Qualitative content analysis method was used. Results: From the data analysis, the main theme “integrity of designing and implementation” and five subthemes as the influencing factors, namely, The “inadequate resources,” “ambiguity in tasks and roles,” “attention to psychosocial atmosphere,” “considering of the delivery culture,” and “incomprehensive training and updating the plan,” were extracted. Conclusion: This research suggests that the success behind implementing a plan in health-care system including the physiological delivery plan depends on the factors that are requiring should be identified and investigated from the designing stage to the implementation stage and after that. Thus, health system policymakers and planners are required to pay attention to diverse above-mentioned aspects in its designing and implementation.