Impact of Intrapartum Nurses' Personal Demographics and Hospital-Specific Characteristics on Labor Support Self-Efficacy

Abstract

In 2020, the United States cesarean birth rate was 32%, nearly an 8% increase from 2000. Cesarean births increase infection risk, blood clots, pelvic pain, and postpartum depression. Labor support has been shown to reduce cesarean births; however, intrapartum (IP) nurses do not universally provide it in hospitals. The purpose of this study is to explore relationships between IP nurses' personal demographics and hospital-specific characteristics with their self-efficacy in providing labor support. This study is a secondary analysis of data collected from online surveys in April-August 2020. Participants include members of Association for Women's Health, Obstetric, and Neonatal Nurses (AWHONN) Texas Chapter who identify as IP nurses (N=106) and were recruited through AWHONN to take two surveys: personal and hospital-specific characteristics and the Self-Efficacy in Labor Support Scale (SELSS). Correlational and descriptive analyses were conducted on personal and hospital data to determine the impact on self-efficacy in labor support. Scores for SELSS range from 20 to 98 with a mean of 85. Results identify three prominent predictors of labor support, including years worked as an IP nurse (r=0.48, p<0.001), professional certification obtainment (p<0.05), and personal birth experience (p<0.05). Hospital characteristics including nurse-to-patient ratio, geographic location, and hospital type were not predictors of self-efficacy. Intrapartum nurses with personal birth experience hold a unique perspective having been in the patient role, thus influencing care they provide. Further, experienced IP nurses gain confidence in labor support skills through practice. Experienced IP nurses should be encouraged to mentor new nurses in providing labor support. Despite the correlation between certification and self-efficacy, there lacks a national certification on labor support. National organizations should create a labor support certification to educate on best-practices and quality care for laboring women thus decreasing cesarean births and improving birth outcomes.