A Research Agenda to Improve Incidence and Outcomes of Assisted Vaginal Birth; [Programme De Recherche Pour Ameliorer L'incidence Et Les Effets De L'accouchement Vaginal Assiste]; [Un Programa De Investigacion Para Mejorar La Incidencia Y Los Resultados Del Parto Vaginal Asistido]

A Research Agenda to Improve Incidence and Outcomes of Assisted Vaginal Birth; [Programme De Recherche Pour Ameliorer L'incidence Et Les Effets De L'accouchement Vaginal Assiste]; [Un Programa De Investigacion Para Mejorar La Incidencia Y Los Resultados Del Parto Vaginal Asistido] Publisher Pubmed

Betran AP¹ ; Torloni MR² ; Althabe F³ ; Altieri E⁴ ; Arulkumaran S⁵ ; Ashraf F⁶ ; Bailey P⁷ ; Bonet M¹ ; Bucagu M⁸ ; Clark E⁹ ; Changizi N¹⁰ ; Churchill R⁹ ; Dominico S¹¹ ; Downe S¹² Show All Authors

Betran AP¹
Torloni MR²
Althabe F³
Altieri E⁴
Arulkumaran S⁵
Ashraf F⁶
Bailey P⁷
Bonet M¹
Bucagu M⁸
Clark E⁹
Changizi N¹⁰
Churchill R⁹
Dominico S¹¹
Downe S¹²
Draycott T¹³
Faye A¹⁴
Feeley C¹⁵
Geelhoed D¹⁶
Gherissi A¹⁷
Gholbzouri K¹⁸
Grupta G¹⁹
Hailegebriel TD¹⁹
Hanson C²⁰
Hartmann K²¹
Hassan L²²
Hofmeyr GJ²³
Jayathilaka AC²⁴
Kabore C²⁵
Kidula N²⁶
Kingdon C²⁷
Kuzmenko O²⁸
Lumbiganon P²⁹
Mola GDL³⁰
Moran A⁸
De Muncio B³¹
Nolens B³²
Opiyo N¹
Pattinson RC³³
Romero M³⁴
Van Roosmalen J³⁵
Siaulys MM³⁶
Camelo JS³⁷
Smith J³⁸
Sobel HL³⁹
Sobhy S⁴⁰
Sosa C⁴¹
Souza JP⁴²
Hoopebender PT⁴³
Thangaratinam S⁴⁴
Varallo J⁴⁵
Wright A⁴⁶
Yates A⁴⁷
Oladapo OO¹

Show Affiliations

1. Department of Sexual and Reproductive Health and Research, World Health Organization, Avenue Appia 20, Geneva, 1202, Switzerland
2. EBH Postgraduate Programme, Department of Medicine, Sao Paulo Federal University-UNIFESP, Sao Paulo, Brazil
3. Buenos Aires, Argentina
4. Behavioural Insights Unit, Department of Communications, World Health Organization, Geneva, Switzerland
5. St George's University of London, London, United Kingdom
6. Department of Obstetrics & Gynaecology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh
7. Reproductive, Maternal, Newborn and Child Health, FHI 360, Durham, NC, United States
8. Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
9. Maternal Child Health and Nutrition, USAID Bureau for Global Health, Arlington, United States
10. Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
11. Thamini Uhai (Value Life), Tanzania
12. Department of Midwifery, University of Central Lancashire, Preston, United Kingdom
13. The Chilterns, Southmead Hospital, Bristol, United Kingdom
14. Reproductive, Maternal, Newborn, Child and Adolescent Health Unit, Ministry of Health, Gambia
15. School of Community Health and Midwifery, University of Central Lancashire, Preston, United Kingdom
16. Tete, Mozambique
17. High School for Health Science and Techniques, University of Tunis El Manar, Tunis, Tunisia
18. WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
19. United Nations Children's Fund, New York, United States
20. Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
21. Mother Hood e.V.-Federal Parents' Initiative for the Protection of Mother and Child during Pregnancy, Bonn, Germany
22. Women's Health Intervention and Development Initiative, Islamabad, Pakistan
23. Department of Obstetrics and Gyneacology, University of Botswana, Gaborone, Botswana
24. WHO Regional Office for South-East Asia, New Delhi, India
25. Institut de Recherche en Sciences de la Sante, Ouagadougou, Burkina Faso
26. WHO Regional Office for Africa, Brazzaville, Congo
27. Research in Childbirth and Health Unit, University of Central Lancashire, Preston, United Kingdom
28. WHO Regional Office for Europe, Copenhagen, Denmark
29. Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
30. School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
31. WHO Regional Office for the Americas, Montevideo, Uruguay
32. Department of Obstetrics and Gyneacology, Canisius-Wilhelmina Hospital, Nijmegen, Netherlands
33. Maternal and Infant Health Care Strategies unit, University of Pretoria, Pretoria, South Africa
34. Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina
35. Working Party for International Safe Motherhood and Reproductive Health, Groningen, Netherlands
36. Hospital e Maternidade Santa Joana, Sao Paulo, Brazil
37. Riberao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil
38. Maternal, Newborn & Child Health, Bill & Melinda Gates Foundation, Seattle, WA, United States
39. WHO Regional Office for Western Pacific, Manila, Philippines
40. omen's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
41. Centro Hospitalario Pereira Rossel, Montevideo, Uruguay
42. Sao Paulo, Brazil
43. United Nations Population Fund, Geneva, Switzerland
44. Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
45. Jhpiego, Baltimore, MD, United States
46. International Federation of Gynaecologists and Obstetricians (FIGO), London, United Kingdom
47. International Confederation of Midwives (ICM), The Hague, Netherlands

Source: Bulletin of the World Health Organization Published:2023

Abstract

Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal and childbirth outcomes. However, although the proportion of births by caesarean section has increased during the last few decades, the use of assisted vaginal birth has declined. This is particularly the case in low-and middle-income countries, despite an assisted vaginal birth often being less risky than caesarean birth. We therefore conducted a three-step process to identify a research agenda necessary to increase the use of, or reintroduce, assisted vaginal birth: after conducting an evidence synthesis, which informed a consultation with technical experts who proposed an initial research agenda, we sought and incorporated the views of women’s representatives of this agenda. This process has allowed us to identify a comprehensive research agenda, with topics categorized as: (i) the need to understand women’s perceptions of assisted vaginal birth, and provide appropriate and reliable information; (ii) the importance of training health-care providers in clinical skills but also in respectful care, effective communication, shared decision-making and informed consent; and (iii) the barriers to and facilitators of implementation and sustainability. From women’s feedback, we learned of the urgent need to recognize labour, childbirth and postpartum experiences as inherently physiological and dignified human processes, in which interventions should only be implemented if necessary. The promotion and/or reintroduction of assisted vaginal birth in low-resource settings requires governments, policy-makers and hospital administrators to support skilled health-care providers who can, in turn, respectfully support women in labour and childbirth. © 2023, World Health Organization. All rights reserved.

2. Effect of Iran's Normal Delivery Promotion Plan on the Cesarean Delivery Rates: An Interrupted Time Series Study, HAYAT (2020)

3. Women's Experiences With Implementation of the Physiologic Birth Program in Iran: A Qualitative Content Analysis Study, Frontiers in Global Women's Health (2023)

4. A Global Study of the Association of Cesarean Rate and the Role of Socioeconomic Status in Neonatal Mortality Rate in the Current Century, BMC Pregnancy and Childbirth (2022)

5. Women's Perspectives on Health Facility and System Levels Factors Influencing Mode of Delivery in Tehran: A Qualitative Study, Reproductive Health (2019)

6. Prevalence of and Reasons for Women’S, Family Members’, and Health Professionals’ Preferences for Cesarean Section in Iran: A Mixed-Methods Systematic Review, Reproductive Health (2021)

7. Assessment of the Clinical Outcomes and Complications of Hysteroscopic and Laparoscopic Approaches in the Treatment of Symptomatic Isthmocele: An Observational Study, International Journal of Gynecology and Obstetrics (2023)

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Style	Citing Format
MLA	Betran AP, et al.. "A Research Agenda to Improve Incidence and Outcomes of Assisted Vaginal Birth; [Programme De Recherche Pour Ameliorer L'incidence Et Les Effets De L'accouchement Vaginal Assiste]; [Un Programa De Investigacion Para Mejorar La Incidencia Y Los Resultados Del Parto Vaginal Asistido]." Bulletin of the World Health Organization, vol. 101, no. 11, 2023, pp. 723-729.
APA	Betran AP, Torloni MR, Althabe F, Altieri E, Arulkumaran S, Ashraf F, Bailey P, Bonet M, Bucagu M, Clark E, Changizi N, Churchill R, Dominico S, Downe S, Draycott T, Faye A, Feeley C, Geelhoed D, Gherissi A, ... Oladapo OO (2023). A Research Agenda to Improve Incidence and Outcomes of Assisted Vaginal Birth; [Programme De Recherche Pour Ameliorer L'incidence Et Les Effets De L'accouchement Vaginal Assiste]; [Un Programa De Investigacion Para Mejorar La Incidencia Y Los Resultados Del Parto Vaginal Asistido]. Bulletin of the World Health Organization, 101(11), 723-729.
Chicago	Betran AP, Torloni MR, Althabe F, Altieri E, Arulkumaran S, Ashraf F, Bailey P, et al.. "A Research Agenda to Improve Incidence and Outcomes of Assisted Vaginal Birth; [Programme De Recherche Pour Ameliorer L'incidence Et Les Effets De L'accouchement Vaginal Assiste]; [Un Programa De Investigacion Para Mejorar La Incidencia Y Los Resultados Del Parto Vaginal Asistido]." Bulletin of the World Health Organization 101, no. 11 (2023): 723-729.
Harvard	Betran AP et al. (2023) 'A Research Agenda to Improve Incidence and Outcomes of Assisted Vaginal Birth; [Programme De Recherche Pour Ameliorer L'incidence Et Les Effets De L'accouchement Vaginal Assiste]; [Un Programa De Investigacion Para Mejorar La Incidencia Y Los Resultados Del Parto Vaginal Asistido]', Bulletin of the World Health Organization, 101(11), pp. 723-729.
Vancouver	Betran AP, Torloni MR, Althabe F, Altieri E, Arulkumaran S, Ashraf F, et al.. A Research Agenda to Improve Incidence and Outcomes of Assisted Vaginal Birth; [Programme De Recherche Pour Ameliorer L'incidence Et Les Effets De L'accouchement Vaginal Assiste]; [Un Programa De Investigacion Para Mejorar La Incidencia Y Los Resultados Del Parto Vaginal Asistido]. Bulletin of the World Health Organization. 2023;101(11):723-729.
BibTex	@article{ author = {Betran AP and Torloni MR and Althabe F and Altieri E and Arulkumaran S and Ashraf F and Bailey P and Bonet M and Bucagu M and Clark E and Changizi N and Churchill R and Dominico S and Downe S and Draycott T and Faye A and Feeley C and Geelhoed D and Gherissi A and Gholbzouri K and Grupta G and Hailegebriel TD and Hanson C and Hartmann K and Hassan L and Hofmeyr GJ and Jayathilaka AC and Kabore C and Kidula N and Kingdon C and Kuzmenko O and Lumbiganon P and Mola GDL and Moran A and De Muncio B and Nolens B and Opiyo N and Pattinson RC and Romero M and Van Roosmalen J and Siaulys MM and Camelo JS and Smith J and Sobel HL and Sobhy S and Sosa C and Souza JP and Hoopebender PT and Thangaratinam S and Varallo J and Wright A and Yates A and Oladapo OO}, title = {A Research Agenda to Improve Incidence and Outcomes of Assisted Vaginal Birth; [Programme De Recherche Pour Ameliorer L'incidence Et Les Effets De L'accouchement Vaginal Assiste]; [Un Programa De Investigacion Para Mejorar La Incidencia Y Los Resultados Del Parto Vaginal Asistido]}, journal = {Bulletin of the World Health Organization}, volume = {101}, number = {11}, pages = {723-729}, year = {2023} }
RIS	TY - JOUR AU - Betran AP AU - Torloni MR AU - Althabe F AU - Altieri E AU - Arulkumaran S AU - Ashraf F AU - Bailey P AU - Bonet M AU - Bucagu M AU - Clark E AU - Changizi N AU - Churchill R AU - Dominico S AU - Downe S AU - Draycott T AU - Faye A AU - Feeley C AU - Geelhoed D AU - Gherissi A AU - Gholbzouri K AU - Grupta G AU - Hailegebriel TD AU - Hanson C AU - Hartmann K AU - Hassan L AU - Hofmeyr GJ AU - Jayathilaka AC AU - Kabore C AU - Kidula N AU - Kingdon C AU - Kuzmenko O AU - Lumbiganon P AU - Mola GDL AU - Moran A AU - De Muncio B AU - Nolens B AU - Opiyo N AU - Pattinson RC AU - Romero M AU - Van Roosmalen J AU - Siaulys MM AU - Camelo JS AU - Smith J AU - Sobel HL AU - Sobhy S AU - Sosa C AU - Souza JP AU - Hoopebender PT AU - Thangaratinam S AU - Varallo J AU - Wright A AU - Yates A AU - Oladapo OO TI - A Research Agenda to Improve Incidence and Outcomes of Assisted Vaginal Birth; [Programme De Recherche Pour Ameliorer L'incidence Et Les Effets De L'accouchement Vaginal Assiste]; [Un Programa De Investigacion Para Mejorar La Incidencia Y Los Resultados Del Parto Vaginal Asistido] JO - Bulletin of the World Health Organization VL - 101 IS - 11 SP - 723 EP - 729 PY - 2023 ER -

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