KALI update

The KALI (Knowledge and Attitudes of Labor Interventions) Questionnaire is launched, and I have almost a dozen responses! But, the physicians aren’t beating my door down to take it. I guess I expected that, but it’s intimidating to have to go out and recruit subjects. I am going to be visiting physician’s offices like a drug rep with no food budget, begging for a few minutes of their time.

I loaded my responses into SPSS. I was able to print out frequency charts for the different questions. Fun!!

I am loathe to make any sweeping statements about the responses that I have already received. I have been pleasantly surprised with the variety and balance in the responses so far. I was surprised that one physician selected “strongly agree” that “I would refer out any patient who wants to hire a doula.” Really? I guess I am naive, but I was hoping for more ignorance of doulas than antipathy. Maybe the question is worded poorly – maybe they have a referral list for doulas? Geez, I have got to stop getting hung up on the wording! Well, the first survey is a learning experience. There is one local hospital that has apparently banned doulas recently, so maybe it’s someone who is there?

I think it is OK to talk about the responses so far without jeopardizing the study if I speak generally and don’t overstep. If there were obstetricians in my area who were reading my blog, that would be a very different story. I wonder if any of them are going to google the name of my study and find this. If they’ve already taken the study, I guess it doesn’t matter. This is getting a little meta.

My very small pool of respondents has a good amount who aren’t huge fans of elective cesarean. Most are fine with it, but I am happy to see it is truly a controversial issue, not just among natural birth advocates but practicing ob/gyns in an area with a high cesarean rate. There is also a variety of opinion on restricting food and water during labor, upright positions, and even intermittent monitoring, which is uncommon to nonexistent in most local hospitals. Good. A monolithic response would mean the survey was poorly written.

I am surprised how low the numbers are on institutional barriers to VBAC. I think most of the responses are from one institution so far, though, and it seems they do not have an institutional policy against VBAC. And, neither does their insurance company. But, now that I think of it, the responses I got on practice types and malpractice insurance coverage were varied, so it is probably a varied group of respondents so far. Hmmm. The respondents so far seem to be more comfortable with VBAC in general than I had expected.

Not a lot of episiotomy defenders in the set so far. I was surprised to see how many said they agreed that episiotomy should be avoided at all costs, and that a patient has a right to refuse an episiotomy. The physician who is the course director for Women’s Health at my medical school gave me feedback on my survey, and he said he found that question very provocative. He would have a serious problem with a woman wanting to refuse any episiotomy.

Most of the doctors so far think Pitocin benefits most laboring women. That matches up with practice patterns I have read.

Anyway, I will am doing an oral presentation at our medical school Research Day. I have two weeks to get more responses and put together a power point. If I can get in front of a group and talk about my preliminary results, I can write about them on my blog, right? Ehhhhhh…..

Anyway, this is an unorthodox entry into the Lamaze Healthy Birth Blog Carnival on avoiding interventions that are not medically necessary. Speaking of unnecessary interventions, I’m off to read the new Cochrane review on restricting food and liquid intake during labor. Thanks for posting about it, Amy.

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2 Comments

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2 responses to “KALI update

  1. Let me know if there’s anything I can do to help get the word out.

    • MomTFH

      Unfortunately, I selected practicing in my local tri-county area as part of the inclusion criteria. So, I just need to pound the pavement around here. I do hope to test it out in other areas. I got contacted from a midwife in Jordan (cool!) who is adapting it for use there. Really! I have also been approached by people from Stanford and NYU Langone who are interested in using it. I want to take it for a test drive first, and verify it.

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