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Do Canadian nurses differ in their attitudes towards birth? Liva, Sarah Jane


Background: With a population estimated at 14,192, perinatal nurses are the largest group of Canadian maternity care providers. Knowledge about similarities and differences in nurses’ attitudes towards practice approaches can facilitate strategies to decrease intervention use, and to promote physiologic birth and care providers’ collaboration. Methods: The National Maternity Care Attitudes Study (NMCAS) study surveyed care providers about their attitudes towards birth using a web or paper-based survey. The nursing sample consisted of 545 nurses from across Canada. Using exploratory factor analysis, the NMCAS study revealed nine themes of care provider attitudes, including attitudes towards doulas, electronic fetal monitoring, epidural analgesia, episiotomy, factors that decrease the caesarean section rate, the safety of birth by place or mode (vaginal or caesarean), and the importance of vaginal birth. In this secondary analysis, Chi-Square, ANOVA, Kruskal-Wallis, and multiple regression were used to examine nurses’ demographic group differences in relationship with nurses’ scale scores. Results: Tertiary hospital level of employment predicted more positive attitudes towards epidural analgesia and less positive attitudes towards the importance of vaginal birth. Nurses were significantly more likely to select an obstetrician for their care (adjusted standardized residual, 3.8) if they worked at a tertiary hospital and select a family practitioner if they worked at a level one hospital (adjusted standardized residual, 2.5). Nurses’ selection of an obstetrician for their care predicted less positive attitudes towards the safety of birth, the importance of vaginal birth, and more positive attitudes towards electronic fetal monitoring, episiotomy, and epidural analgesia. Conclusions: Nurses’ attitudes may be influenced by exposures in their workplace and the predominant provider with whom they have contact. Further research is needed to understand relationships between nurses’ attitudes and practice behaviours.

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