Date of Conferral



Doctor of Nursing Practice (DNP)




Eileen Fowles


Cesarean delivery is one of the most frequently performed surgical procedures in the United States with 1 in 3 women giving birth by cesarean section. Nurses play a significant role during the labor and delivery process; yet in a hospital in west Texas, nurses lacked knowledge of the current evidence-based obstetric guidelines that were developed to reduce the primary cesarean delivery rates and associated complications. The purpose of this project was to evaluate the content of educational materials developed to inform obstetrical nurses and midwives about labor support strategies to avoid cesarean delivery. Guided by Knowles's whole-part-whole model, a presentation was developed that included evidence-based guidelines and labor-support strategies for positioning and pain management to decrease the choice of cesarean section when not indicated. A 9-member panel with at least 5 years obstetrical expertise evaluated the materials. Based on a descriptive analysis of questionnaire data, experts had a 100% level of agreement that while the educational program material had the potential to promote nursing care practices that would decrease the number of primary cesarean deliveries, changing clinical delivery practices would likely be met with staff resistance. An evidence-based educational program with preventive strategies to decrease primary cesarean deliveries might produce positive social change by prompting obstetric teams to choose these preferred alternatives to avoid to cesarean delivery, and subsequently, decrease associated complication rates, promote faster maternal recovery after childbirth, and decrease the financial burden on the health care system.