Doctor of Nursing Practice (DNP) Projects

Date of this Version


Embargo Date


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Post-BSN for Nurse Anesthetists (DNP-NA)


cesarean delivery, cesarean section, avoidable c-section, patient education, education intervention, low-risk mothers, childbirth plans, c-section knowledge, childbirth confidence, conversation with providers


Objective: To increase participant knowledge regarding avoidable cesarean sections (CS), and confidence to self-advocate and initiate conversation with their health care team regarding their birth plans, with a long-term goal of decreasing avoidable CS.

Design: Quality improvement initiative.

Setting/Local Problem: Obstetrics and gynecology clinic for low-income, underserved patients affiliated with an urban teaching hospital in Philadelphia, Pennsylvania.

Participants: Low-risk expectant mothers without prior cesarean sections.

Intervention/Measurements: Based on available literature, our educational intervention for the project included a brief video and modified pamphlet with information directly from the My Birth Matters free consumer toolkit. The intervention process consisted of a pre-intervention survey, video and modified pamphlet intervention, and post-intervention survey.

Results: Following implementation of the educational intervention, post-intervention survey results demonstrated statistically significant increases for both knowledge (t=5.165, p=<0.001) and confidence (t=2.563, p=0.017) scores, and 93% of participants reported hearing new information.

Conclusion: This quality improvement initiative was successful in educating participants regarding CS and increasing confidence to self-advocate. Due to the ease of implementation and potential magnitude of impact, low-risk pregnant women would benefit from receiving this valuable information about CS. Due to the COVID-19 pandemic, this also provides clinics an opportunity to continue patient education, whether in-person education is feasible or not. If long-term outcomes indicate reduction of avoidable CS, this brief educational intervention will serve as a simple, easy tool to implement in a variety of patient populations to address the rising rates of CS in the United States.



Date Posted: 25 February 2022