Tor 23 maj / År 42 / Nr 1 2024

Swedish researchers involved in prominent European care project – aiming at increasing the percentage of normal births after having a previous C-section

Giving birth by cesarean section brings increased health risks for both mother and child. Researchers at the Sahlgrenska Academy, University of Gothenburg, have together with colleagues in three other European countries been granted three million euros from the European Union to support a project aimed at increasing the percentage of vaginal births after having a previous C-section. The project is led by midwife and researcher Ingela Lundgren at the Sahlgrenska Academy, Institute of Health and Care Sciences.

The number of C-sections are increasing steadily worldwide, but frequency still varies greatly between different countries. In Sweden, about 17 percent of the children are delivered using C-section, while in Italy the figure is as high as 38 percent. Part of the increase is due to women who have previously used caesarean tend to have the method for the next delivery.

Promoting natural birth
The project OptiBirth now receives three million euros from the EU to increase the proportion of women who give birth vaginally after a previous C-section. Ingela Lundgren, researcher at the Sahlgrenska Academy, is managing the project together with researchers from Ireland, Belgium and England.
“By focusing on the women’s perspectives, and studying all healthcare practices considered around childbirth, we want to increase the ability of women to give birth normally after a previous cesarean section”, she says.
Sweden, Finland and the Netherlands all have a high proportion of women giving birth vaginally after previous C-sections, from about 45 and up to a staggering 55 percent; these countries are therefore internationally prominent examples.
“We know that the figure varies internationally. For example, in Germany and Ireland, only about 30 percent of women give birth vaginally after a previous C-section, although vaginal birth is the best option considering the health of both mother and baby”, Ingela Lundgren continues.

A three-step project to improve care and support
In the first part of the project, researchers in six countries with high respective low percentage of vaginal births after a previous C-section interview women, their partners as well as doctors and midwives in order to identify what may cause these differences.
The next step is to test a new, innovative program at 15 obstetric units in Germany, Ireland and Italy, countries characterised as having a low percentage of vaginal births after a previous cesarean. Ingela Lundgren on the aim:
“The aim is for women to have better support, but also to become more involved in their care, including changes in health care practices and new technology programs and training”.
In the last part of OptiBirth the socio-economic aspects will be studied.

The project OptiBirth
The research project OptiBirth, involving twelve research groups from eight countries, received the highest ranking of all applications for EU research initiative FP7 on health and innovation, “Improving the organization of health service delivery” and has come about through cooperation within the EU-COST network “Childbirth Cultures, Concerns, and Consequences: Creating a dynamic EU framework for optimal maternity care”.

The Institute of Health and Care Sciences
The Institute of Health and Care Sciences was established in 2002 and is today one of six institutes comprising the Sahlgrenska Academy, Faculty of Health Sciences at the University of Gothenburg. The overall vision of the institute is to pursue excellence in education, research and clinical practice within the field of health care sciences in order to promote health and wellbeing and to advance care and treatment aimed at relieving illness and suffering. The overriding approach to care stresses the central and participatory role of the patient, i.e. person-centered care.