Describing how Expert Labour and Delivery Registered Nurses Work to Optimize Outcomes for Intrapartum Patients at Risk of Unplanned Caesarean Section

Unplanned caesarean section (c-section) births are common and can have significant negative psychological and emotional outcomes for patients. Expert labour and delivery registered nurses (L&D RNs) are well-positioned to anticipate the need for an unplanned c-section and to support at-risk patients. This qualitative interpretive descriptive study explored how expert L&D RNs anticipate unplanned c-sections and support those patients they deem to be at imminent risk of requiring the procedure. A purposive sample of 16 L&D RNs with minimum five years of L&D nursing experience in Ontario participated in semi-structured telephone interviews. Conventional content analysis was used to analyze interview data. Findings describe tacit knowledge used to anticipate unplanned c-sections, and therapeutic nurse-patient relationships developed to individualize support. The findings bring attention to tacit knowledge that expert L&D RNs use in practice and inform future research into the effectiveness of how expert nurses’ interventions support patients at risk of unplanned c-section.