Date of Award

Spring 2020

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)


Leadership and Advanced Nursing Practice

Committee Chair

Dr. Cathy Hughes

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Lisa Morgan


Intrapartum nurses’ beliefs influence nursing behavior and nursing interventions during labor and birth. Assessing these beliefs in a regional hospital in the Southeastern United States was the focus of the doctoral project. Before the project, there was no objective data that assessed individual nurse’s beliefs and birth practices in the labor and delivery unit, or among the nursing staff as a whole. A knowledge gap existed in understanding if the nursing culture valued, promoted, and supported intended vaginal birth. Nursing leadership recognized that the overall cesarean birth rate and primary cesarean birth rate in the hospital were similar to State statistics and desired implementation of Safe Reduction of Primary Cesarean Births: Supporting Intended Vaginal Births (2015) patient safety bundle in the labor and delivery unit. Establishing a clear understanding of whether nurses’ beliefs aligned more with medicalized birth practices or normal birth practices provided valuable information for leadership and began the first step of implementation, Readiness. The Intrapartum Nurse’s Beliefs Related to Birth Practices (Adams, 2012) instrument was utilized to establish that 93% of nurses who participated in the survey have birth beliefs that more closely align with normal birth practices. The results of the survey illustrate that the nursing culture values normal birth. Study results indicate that the intrapartum nurse culture is ripe for presenting education and training that builds knowledge and skills to support intended vaginal birth. Understanding the relationship of beliefs related to practice is key to predicting future intentions of care. Recommendations and the next steps to utilizing the patient safety bundle are discussed.