138 Chapter 6 the Netherlands, large variations in interventions were found, but trends in intervention rates between midwifery and obstetric care were comparable in the same region (4). This observation might suggest that an individual maternity care professional’s attitude is subject to regional culture. These circumstances at organizational level create practice variation at meso-level influencing individual decision-making (9). Birth beliefs are an important factor in the attitude of maternity care professionals towards childbirth interventions, and there are indications that birth beliefs differ between maternity care professionals (10–12). We would like to investigate in a larger population whether birth beliefs are a possible factor explaining practice variation between the different regions in the Netherlands. A validated tool to assess birth beliefs is available for pregnant women but is not yet validated for maternity care professionals (14). Therefore, the aim of this study is to validate the Birth Beliefs Scale (BBS) for maternity care professionals. The objectives of the current study are to: 1. evaluate the content validity of the BBS for maternity care professionals 2. evaluate the internal reliability of the BBS for maternity care professionals 3. evaluate the known-group discriminant validity of the BBS 4. examine the potential relationships between different regions in the Netherlands and birth beliefs
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