Bulletin of the World Health Organization

Identifying barriers and facilitators towards implementing guidelines to reduce caesarean section rates in Quebec

Nils Chaillet, Eric Dubé, Marylène Dugas, Diane Francoeur, Johanne Dubé, Sonia Gagnon, Lucie Poitras, Alexandre Dumont

Volume 85, Number 10, October 2007, 791-797

Table 3. Identified facilitators to the implementation of practical guidelines

Topics
Factors influencing use of induction of labour at term guideline
• Provide the highest expected birth date to women instead of the mean expected birth date
• Adoption of a departmental policy of induction at term, including standardization of information provided to women
Factors influencing use of fetal health surveillance in labour guideline
• Following the guidelines represents the best practice and the optimal way to avoid the charges of malpractice (lawsuits)
• Possibility for senior obstetricians to promote the adoption of intermittent auscultation to junior obstetricians
• Presence of strong nursing and obstetric leadership to support the guidelines recommendations
Factors influencing use of operative vaginal birth guideline
• Possibility to refer a patient to a more experienced colleague
Factors influencing use of vaginal birth after previous caesarean birth guideline
• Possibility for women to request a second opinion