Leads: Dr Beck Taylor, Ms Fiona Cross-Sudworth

Dates: October 2022-April 2023

Background:

This qualitative study will explore factors that influence implementation of two high-quality intrapartum maternity trials. BUMPES (2017) showed that lying down in the second stage of labour resulted in more spontaneous vaginal births in nulliparous women with epidural analgesia, with no apparent disadvantages. RESPITE (2018) found use of intravenous remifentanil Patient-Controlled Analgesia in labour halved the proportion of women converting to epidural compared to intramuscular pethidine and suggested increases in spontaneous vaginal birth. Recommendations from these trials if implemented have potential to increase the numbers of women having a spontaneous vaginal birth. It is, however, currently unknown whether these trials’ findings are being implemented in practice and if not, the reasons why.

Policy and Practice Partners:

Researchers involved in the original research and UK clinicians who work in NHS intrapartum care.

Aims and Objectives:

What factors influence the implementation of RESPITE and BUMPES trial findings in NHS maternity care?

Objective: to identify factors that influence the implementation of two interventions proven to be effective in clinical trials, through interviews with key informants in academic and NHS clinical practice.

Methods:

Design: Qualitative interview study

Setting: Academics, and clinicians working in intrapartum care, from across the UK.

Participant population: Approximately 30 virtual or telephone/in-person interviews will take place involving the following participants groups: Maternity academics from RESPITE and BUMPES trials (n=8-12), senior midwives (n=8-12) and senior anaesthetists/obstetricians working in NHS Trusts (n=8-12).

Analysis: Data will be analysed deductively using COM-B (Capability, Opportunity and Motivation) theory as well as inductively to identify themes. Underpinned by behavioural science, interviews will explore barriers and facilitators of implementing maternity trial findings into clinical practice and solutions for maximising uptake.

Results:

Project underway.

Conclusions:

Project underway.

Implications for Implementation:

We are researching barriers and facilitators in order to potentially design and implement an intervention to improve uptake.