Regional and clinical guidelines for prevention and care of obstetric anal sphincter injuries - A critical frame analysis

Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved..

OBJECTIVE: Policy documents govern how the prevention and care of obstetric anal sphincter injuries (OASIS) are implemented. Thus, in the absence of Swedish national guidelines on OASIS, differing views may be visible in the regional and local policy documents. Therefore, we aimed to analyse regional and local policies, guidelines, and care programs on the prevention of OASIS and care for OASIS-affected women in a Swedish context by applying a critical frame analysis inspired by Verloo.

DESIGN AND SETTING: A cross-sectional study of existing policy documents from Swedish healthcare regions was performed. The documents were analysed using Verloo's critical frame analysis.

FINDINGS: We found that OASIS was framed as a preventable problem addressed by skilled protective manoeuvres of the healthcare staff. Education, communication, and teamwork were three frames of crucial solutions to minimise the prevalence of OASIS. However, complicating power dimensions between professional groups and between professionals and birthing women were identified. Furthermore, several discursive struggles were found, predominantly regarding the scientific evidence for the suggested prevention and care.

CONCLUSION: The policy documents emphasised that OASIS is preventable, and improved education, communication, and teamwork could diminish the OASIS prevalence. Nevertheless, power dimensions and discursive struggles may challenge the preventive efforts. Furthermore, each Swedish region has the sovereignty to develop its policies, which was reflected in our findings and may imply inequities in care provision. Thus, there is an urgent need to develop comprehensive national high-quality guidelines of high quality for OASIS prevention and care so that all women giving birth have access to equal care and treatment in Sweden.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:119

Enthalten in:

Midwifery - 119(2023) vom: 06. Apr., Seite 103608

Sprache:

Englisch

Beteiligte Personen:

Persson, Margareta [VerfasserIn]
Lindberg, Inger [VerfasserIn]
Öhman, Ann [VerfasserIn]

Links:

Volltext

Themen:

Critical frame analysis
Journal Article
Management
Obstetric anal sphincter injuries
Policy documents
Prevention

Anmerkungen:

Date Completed 10.03.2023

Date Revised 10.03.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.midw.2023.103608

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM352496479