Date of Award

Spring 5-5-2024

Document Type

DNP Project

Project Team Faculty Member

April Schmidt

Project Team Faculty Member

Theresa Marcotte


Vaginal Birth, Cesarean Section, Obstetrics, Labor and Delivery, Patient Satisfaction, Culture Change, ILPQC, Maternal Positioning, Labor Dystocia


Cesarean section is a complex surgical procedure with considerable risk for complications during and after surgery, increasing the likelihood of future pregnancy complications. It is crucial to properly educate patients and nursing staff regarding intentional maternal positioning to facilitate successful vaginal delivery through optimal fetal positioning in the vaginal canal throughout the labor process. This study reviewed 28 participants to determine if intentional maternal positioning can promote vaginal birth and increase patient satisfaction. Participants were pregnant women experiencing protracted labor/labor dystocia without a history of prior c-sections, uterine surgeries, or large gestational age (LGA) newborns. Patients who underwent primary cesarean section for indications other than “failure to progress,” “failure to descend,” or “failed induction” were excluded from the study. Data was collected in a “promoting vaginal birth” checklist provided by the investigators. Participants completed a 5-point Likert scale questionnaire regarding their labor experience. Results showed a 3% decrease in primary c-section rates over the 15-week data collection period, and patient questionnaires demonstrated overall satisfaction in the labor experience, specific to intentional maternal positioning and outcome. Limitations included lack of staff buy-in, sample size, and potential for pelvic inadequacy in nulliparous participants. Further efforts include extended data collection periods over larger sample sizes and applying additional educational materials from ILPQC’s Labor Toolkit to promote vaginal birth, including doula support, second-stage huddle, and standardization of protocols, guidelines, and algorithms. Implications conclude that with evidence-based guidance & support, successful vaginal delivery can increase while promoting patient satisfaction.

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