The Correlation Between Birthing Positions And Lacerations

The National Institute for Health and Clinical Excellence (NICE, 2007) Intrapartum guidelines state that during the first stage of labour women should be encouraged to adopt the position they feel most comfortable in. This is what the student was trying to encourage even though her mentor did not.There are various positions the woman can adopt in labour which are generally grouped into upright and recumbent. The positions classed as upright are; standing, walking, kneeling, squatting, on all fours and sitting, and the recumbent position could include; supine, lithotomy, semi-recumbent or side lying (Johnson and Taylor, 2011). The upright position appeared to be more beneficial in Sarah’s case and the author wants to determine if this is always the case. It is evident that sometimes there will be constraints such as continuous fetal monitoring but it is important that the midwife does

Childbirth is one of the greatest privileges on the earth anyone could have and we, as women, should feel proud to be major contributors for it. Thus, a mother has to play a key role in aiding the healthcare workers to mitigate the health crisis associated with childbirth by performing her duties faithfully. One such associated health crisis is “Premature (preterm) birth” which occurs when the baby is born too early, before 37 weeks of gestational period (CDC, 2015). The rate of preterm birth ranges from 5% to 18% of babies born across 184 countries (WHO, 2015).

In order to obtain an in depth knowledge of the subject of perineal massage in the intrapartum period, an extensive amount of literature needed to be investigated, this was done by accessing the University electronic database, which accessed a vast amount of sources. A search was performed using CINAHL (Cumilative Index to Nursing and Allied Health Literature). CINAHL searches a variety of health journals from around the world. By searching using key words a significant amount of literature was sourced. In order to narrow down the results the search was repeated but key words were combined, this was to access results that were more specific to the subject area. Though this database was useful and provided a vast amount of literature, few of the articles were actually research based, therefore those ones were excluded.

Randomization was used to generate what patient went to which group. The way the patients were chosen eliminated bias because “Randomization was performed according to a computer-generated list by means of sequentially numbered, opaque, sealed envelopes which revealed the allocation of the subject to either induction or expectant management”(Nielsen et al. p. 60). This secure randomization added a great strength to the study. The sample size seemed fairly large, 226 patients were split into 116 for elective induction and 110 to expectant management, although the power analysis was disclosed in this study and determined that 600 patients were required. Only 226 patients were used and because it would take 4 years to reach the required amount of patients, the study was discontinued. This was both a strength and weakness because disclosing this information made the study more honest but the quota needed to reach the best answers was not attained. The study for the 226 patients was pretty standard with the 80% power and alpha at 0.05. T-test and chi square tests were used to compare the proportions between the groups of people. The women were chosen based on the inclusion criteria of being 39 weeks gestation or older, maternal age of more than 17, fetal cephalic presentation, singleton gestation, a candidate for vaginal delivery, and a Bishop score of 5 or greater in nulliparous women and 4 or greater for multiparous women. This inclusion criterion was a concern because both nulliparous women and multiparous women were being tested together. This was a weakness because the labor patterns of a nulliparous woman compared to a multiparous woman are very variable and sure to distort study data. It was also disclosed how gestational age was achieved which included the crown rump test measured in 6-12

The author is a nurse in a level two trauma facility in a community of approximately fifty thousand people in Oregon. The community is a college-town surrounded by a large agricultural area. There is a minimal ethnic diversity within the community. The diversity present occurs mainly from internationally students and faculty from the college. There is a growing population of women who desire low interventional births in the community. The author has worked on the labor and delivery unit of the hospital for the last 14 years. The hospital is the only one in the area to offer trial of labor services to women who have previously undergone a cesarean section. The unit on average experiences around 1000 deliveries annually.

The intent of this paper is to examine effective solutions for reducing cesarean deliveries. Cesarean deliveries involve more risk to both the mother and baby than vaginal births do. Cesarean deliveries have a higher potential of complications than vaginal births. Cesarean deliveries cost more, require longer hospital stays, and require more resources—both human and systemic—than vaginal births.

Over the years birthing methods have changed a great deal. When technology wasn’t so advanced there was only one method of giving birth, vaginally non-medicated. However, in today’s society there are now more than one method of giving birth. In fact, there are three methods: Non-medicated vaginal delivery, medicated vaginal delivery and cesarean delivery, also known as c-section. In the cesarean delivery there is not much to prepare for before the operation, except maybe the procedure of the operation. A few things that will be discussed are: the process of cesarean delivery, reasons for this birthing method and a few reasons for why this birthing method is used. Also a question that many women have is whether or not they can vaginally

For almost all of the previous 25 years roughly, the knowledge of pregnancy, labor, and delivery has changed little for some women. But change is arriving to the most traditional establishing, the hospital.

Medical and technological advances in maternal and neonatal care have significantly reduced maternal and infant mortality and medical interventions have become commonplace and arguably routine. Used appropriately, they can be lifesaving procedures. Routine use, without valid indication though, can transform childbirth from a natural physiologic process and family event into a medical or surgical procedure. Every intervention presents the possibility of unwanted effects and subsequent risks that can potentiate more interventions with their own inherent risks (McKinney, 2014).

North America’s childbirth conditions and practice have been revolutionized throughout time. Today, many aspects of childbirth are carefully inspected to create, in their opinion, the healthiest environment for the women and child. The vast majority of Americans birthing environment takes place at a “hospital, birthing-centers, and homes,” while “planned home births” are fewer then 1% of birth (347). When having a planned at home birth, a birthing center will bring all the required equipment to your

Vaginal birth has been identified as a risk factor for levator injury. Overstretching and damage to levator muscle, particularly to the pubococcygeal muscle, which is the shortest and most medial. Operative vaginal delivery further increases the risk of levator ani

Critique of Borders et al.’s Study (2013) “Midwives’ Verbal Support of Nulliparous Women in Second-Stage Labor”

The implementation of this routine tradition has been linked to a lack of education of the nurses of the various benefits of upright birthing positions and thus deficient knowledge of the mothers on their different options for positioning during delivery. Furthermore, research has determined that upright positions for delivery, such as squatting and sitting, yield more positive outcomes physically and psychologically for the mother and the baby than gravity-neutral supine positions. Nurses and other obstetric medical professionals are reluctant to “change their ways” of practice because of barriers to obtaining such knowledge related to their scope of practice. It is the job of the nursing managers on the unit to educate their floor nurses on the benefits of upright delivery positions and the more detrimental effects of supine delivery positions so their patients can have full knowledge and control of the birthing process when deciding on a birthing position as to achieve the most optimal delivery experience as possible.

Hands on or hands off the perineum: a survey of care of the perineum in labour (HOOPS) (Trochez, Waterfield and Freeman, 2011).

Vaginal birth after caesarean (VBAC) is the name used for identifying the method of giving birth vaginally after previously delivering at least one baby through a caesarean section (CS). A trial of labour (TOL) is the term used to describe the process of attempting a VBAC. An elected repeat caesarean (ERC) is the other option for women who have had a caesarean in the past. The rates of women choosing to deliver by means of an ERC has been increasing in many countries, this is typically due to the common assumption that there are too many risks for the baby and mother (Knight, Gurol-Urganci, Van Der Meulen, Mahmood, Richmond, Dougall, & Cromwell, 2013). The success rate of VBAC lies in the range of 56 - 80%, a reasonably high success rate, however, the repeat caesarean birth rate has increased to 83% in Australia (Knight et al., 2013). It is essential to inform women of the contraindications, success criteria, risks, benefits, information on uterine rupture and the role of the midwife in relation to considering attempting a VBAC (Hayman, 2014). This information forms the basis of an antenatal class (Appendix 1) that provides the necessary information to women who are considering attempting a VBAC and can therefore enable them to make their own decision regarding the mode of birth.