Alameddine M, Saleh S, Natafgi N Assessing healthcare professional’ readiness for reporting quality and patient safety indicators at primary health-care centers in Lebanon: a national cross-section survey. Human Resources for Health. 2015; 13:(37)

Braun V, Clarke V Using thematic analysis in psychology. Qualitative Research in Psychology. 2006; 3:77-101

Caughey AB, Sundaram V, Kaimal AJ, Cheng YW, Gienger A, Little SE, Lee JF, Wong L, Shaffer BL, Tran SH, Padula A, McDonald KM, Long EF, Owens DK, Bravata DM Maternal and neonatal outcomes of elective induction of labor.: Evidence Report/Technology Assessment; 2009

Hatamleh R, Sinclair M, Kernohan WG, Bunting B Technological childbirth in northern Jordan: descriptive findings from a prospective cohort study. Evidence-Based Midwifery. 2008; 6:(4)130-135

Hatamleh R, Abujilban S, AbuAbed ASA, Abuhammad S The effects of a childbirth preparation course on birth outcomes among nulliparous Jordanian women. Midwifery. 2019; 72:23-29

Holt DT Are you ready? How health professionals can comprehensively conceptualize readiness for change. Journal of General Internal Medicine. 2010; 25:50-55

Khresheh R, Homer C, Barclay L A comparison of labor and birth outcomes in Jordan with WHO guidelines: a descriptive study using a new birth record. Midwifery. 2009; 25:(6)e11-e18

Statistical book.Jordan: Amman; 2018

Musie MR, Peu MD, Bhana-Pema V Factors hindering midwives' utilisation of alternative birth positions during labor in a selected public hospital. African Journal of Primary Health Care and Family Medicine. 2019; 11:(1)e1-e8

Newhouse RP Creating infrastructure supportive of evidence-based nursing practice: leadership strategies. Worldviews on Evidence-Based Nursing. 2007; 4:(1)21-29

Okour A, Alkhateeb M, Amarin Z Awareness of danger signs and symptoms of pregnancy complications among women in Jordan. International Journal of Gynecology and Obstetrics. 2012; 118:(1)11-14

Osterman MJK, Martin JA Recent declines in induction of labor by gestational age. NCHS data brief, no 155.Hyattsville, MD: National Center for Health Statistics; 2014

Sethi R, Tholandi M, Amelia D, Pedrana A, Ahmed S Assessment of knowledge of evidence-based maternal and newborn care practices among midwives and nurses in six provinces in Indonesia. International Journal of Gynecology and Obstetrics. 2019; 144:51-58

Shaban I, Hatamleh R, Khresheh R, Homer C Childbirth practices in Jordanian public hospitals: Consistency with evidence-based maternity care?. International Journal of Evidence-Based Healthcare. 2011; 9:25-31

Silva F, Paixão T, Oliveira S, Leite J, Riesco M, Osava R Care in a birth center according to the recommendations of the World Health Organization. Revista da Escola de Enfermagem da USP. 2013; 47:(5)1031-1038

WHO safe childbirth checklist: implementation guide-improving the quality of facility-based delivery for mothers and newborns.: Geneva; 2015

World Health Organization. WHO recommendations: Intrapartum care for a positive childbirth experience. 2018. (accessed 13 August 2021)

Lack of evidence-based maternal care practices in a governmental hospital in the middle region of Jordan

02 September 2021
Volume 29 · Issue 9



In Jordan, there is an overuse of treatments that were originally designed to manage complications of labour and birth.


To explore the reasons for the non-application of evidence-based practices in maternal care in a Jordanian governmental hospital from the healthcare professionals' perspective.


A descriptive qualitative method was employed in one selected Jordanian governmental hospital. Data were collected by conducting one-to-one, semi-structured interviews with 11 participants, which were subjected to a thematic and content analysis.


There were four main themes: limited human, financial, infrastructural resources and hospital environment; midwives are not autonomous; lack of motivation to apply evidence-based practices; and socio-cultural pressures hinder the usage of new evidence-based practices.


There is a weak application of evidence-based practices in maternal care in a governmental hospital in Jordan. So, it is important to modify maternal healthcare policy to allow greater midwife autonomy, and raise awareness of maternal evidence-based practice.

The healthcare system in Jordan is well developed, and access to healthcare facilities is generally widespread (Ministry of Health [MOH], 2018). Nevertheless, the practice of maternal care in Jordan is still not evidence-based (Khresheh et al, 2009). A previous Jordanian study that examined maternity hospital practices during childbirth and assessed their consistency with evidence-based maternity care practices focused specifically on six practices that were undertaken during labour. These practices were augmentation of labour, continuous electronic fetal monitoring, support in labour, episiotomy, position for birth, and administration of oral fluids during labour (Shaban et al, 2011).

The most important results reported by Shaban et al (2011) were that many of the common childbirth practices that were routinely followed in maternity hospitals in Jordan were not evidence-based. Moreover, not only the beneficial practices were neglected but also the practices of unproven benefit or practices that were potentially harmful were performed. Overall, the study concluded that childbirth practices that were used to assist women in labour were largely inconsistent with the evidence-based practices for normal birth recognised and recommended by the World Health Organization ([WHO], 2018).

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