A Conceptual Framework for Future Research on Mode of Delivery

Abstract

Our goal was to develop a comprehensive conceptual research framework on mode of delivery and to identify research priorities in this topic area through a Delphi process. We convened a multidisciplinary team of 16 experts (North Carolina Collaborative on Mode of Delivery) representing the fields of obstetrics and gynecology, neonatology, midwifery, epidemiology, psychometrics, decision sciences, bioethics, health care engineering, health economics, health disparities, and women’s studies. We finalized the conceptual framework after multiple iterations, including revisions during a one-day in-person conference. The conceptual framework illustrates the causal pathway for mode of delivery and the complex interplay and relationships among patient, fetal, family, provider, cultural, and societal factors as drivers of change from intended to actual mode of delivery. This conceptual framework on mode of delivery will help put specific research ideas into a broader context and identify important knowledge gaps for future investigation.

Appendix

Carla Bann, PhD, RTI International, Research Triangle Park, NC; Norma Gavin, PhD, Impaq International, Columbia, MD; Jeanne-Marie Guise, MD, Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR; Suneeta Krishnan, PhD, RTI International, Research Triangle Park, NC; Miriam Kuppermann, PhD, Department of Obstetrics and Gynecology, Epidemiology & Biostatistics and Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, CA; Matthew Laughon, MD, MPH, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, Anne Lyerly, MD, MA, Department of Obstetrics and Gynecology, Duke University, Durham, NC; Amy MacDonald, CNM, MSN, Department of Obstetrics and Gynecology, Duke University, Durham, NC, Divya Patel, PhD, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; John Thorp, MD, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, NC, Anthony Visco, MD, Department of Obstetrics and Gynecology, Duke University, Durham, NC; Suzanne West, PhD, RTI International, Research Triangle Park, NC; Xiao Xu, PhD, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.