Implementation of evidence-based practices in normal delivery care.

This was a before-and-after audit at one hospital, with no control group, so changes cannot be attributed to the seminar alone. The post-intervention period was not randomly sampled; puerperal records and interviews were selected intentionally. Many professionals were lost or refused across phases, leaving 32 in the post-intervention audit. Medical records had frequent missing data, especially for companion presence, amniotomy, birth position and Kristeller maneuver. The authors did not analyse labour risk or reasons for caesarean section, so the rise in normal delivery cannot be fully explained. Audit criteria were not pre-specified by the JBI, and organisational barriers such as workload, bed shortages and lack of space may have limited change.

Do not conclude that the educational seminar alone improved childbirth care. This was a before-and-after audit at one hospital, with no control group, and the authors note that space changes, workload and other institutional factors may have contributed. Several professional-reported and record-based outcomes did not show a clear change.