Author | Aim | Country (region) | Resource | Setting | Number of participants | Type of participant | Method | Quality assessment |
Melman et al 47 | To explore barriers and facilitators for delivering optimal care as described in clinical practice guidelines. | The Netherlands (European) | High | Rural and urban | 30 | Obstetricians and midwives | Telephone interviews and focus groups | B |
Foureur et al 66 | To explore the views and experiences of providers in caring for women considering VBAC. | Australia (Western Pacific) | High | Urban | 18 | Obstetricians and midwives | Semistructured interviews | B |
Lundgren et al 65 | To explore the views of clinicians from countries with low VBAC rates on factors of importance for improving VBAC rates. | Ireland, Italy and Germany (European) | High | Rural and urban | 71 | Obstetricians, midwives, neonatologist and GP. | Focus groups | A− |
Lundgren et al 64 | To investigate the views of clinicians working in countries with high VBAC rates on factors of importance for improving VBAC rates. | Finland, Sweden and the Netherlands (European) | High | Rural and urban | 44 | Obstetricians and midwives | Interviews and focus groups | A− |
Litorp et al 63 | To explore obstetric caregivers’ rationales for their hospital’s CS rate to identify factors that might cause CS overuse. | Tanzania (African) | Low | Urban | 32 | Obstetricians and midwives | Observation, interviews and focus groups | A |
Marshall et al 62 | To evaluate the ‘Focus on Normal Birth and Reducing Caesarean section Rates’ programme. | UK (European) | High | Rural and urban | 16 | Obstetricians and midwives | Semistructured interviews | B |
Colomar et al 61 | To assess opinions of the determinants of the high rate of caesarean births in Nicaragua as well as possible barriers to and facilitators of optimal caesarean birth rates. | Nicaragua (Americas) | Middle | Unclear | 17 | Doctors and obstetric decision makers | Focus groups | A |
Lofti60 | To explore effective strategies to reduce caesarean delivery rates in Iran. | Iran (Eastern Mediterranean) | Middle | Unclear | 10 | Obstetricians and midwives | Semistructured interviews | C |
Dunn et al 59 | To reduce high rates of ERCS <39 weeks across the Eastern Ontario region. | Canada (Americas) | High | Unclear | 9 | Nursing cirectors and managers | Key informant interviews | C |
Wang and Ding46 | To explore reasons for obstetric medical staff choosing CS for themselves in the absence of medical indication. | China (Western Pacific) | Middle | Urban | 11 | Health professionals | Semistructured interviews | C |
Liu et al 45 | To explore affecting factors of continuing increase in CS rate in rural area. | China (Western Pacific) | Middle | Rural | 9 | Health professionals | Focus groups | C |
Cox58 | To explore the barriers associated with the ACOG VBAC guidelines. | USA (Americas) | High | Rural and urban | 24 | Obstetricians, midwives and an administrator | Semistructured interviews | A- |
Yazdizadeh et al 57 | To identify barriers to reduce the CS rate in Iran, as perceived by obstetricians and midwives as the main behavioural change target groups. | Iran (Eastern Mediterranean) | Middle | Urban | 26 | Hospital directors, obstetricians and midwives | In-depth interviews | A− |
Wanyonyi et al 56 | To determine perceptions on the practice of VBAC among maternity service providers in East Africa and possible solutions (including acceptability of evidence, guidelines, and audit). | Kenya, Uganda, Tanzania and Ethiopia (African) | Low | Unclear | 63 | Doctors and midwives | Semistructured questionnaire | C− |
Chen et al 44 | To explore informed choice and autonomy of uterine-incision delivery making in China. | China (Western Pacific) | Middle | Urban | 51 | Health professionals | In-depth interviews | D |
Chaillet and Dumont39 | To investigate obstetricians perceptions of clinical practice guidelines and to identify the barriers to, facilitators of, and obstetricians’ solutions for implementing these guidelines in practice. | Canada (Americas) | High | Urban | 27 | Obstetricians | Focus groups and semistructured interviews | C |
Kamal et al 54 | To explore the views of health professionals on the factors influencing repeat CS. | UK (European) | High | Urban | 25 | Doctors and midwives | Semistructured interviews | A |
ACOG, American College of Obstetrician and Genecologists; CS, caesarean section; ERCS, elective repeat caesarean section; GP, general practitioner; VBAC, vaginal birth after caesarean.