Effects of continuous intrapartum professional support on childbirth outcomes

Hodnett, Ellen; Osborn, Richard

doi:10.1002/nur.4770120504

Cited by 121 publications

(76 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The construct validity of the LAS has also been supported by evidence from a series of studies [48-50]. In the current study, the LAS showed good internal consistency reliability with a Cronbach’s alpha of 0.82.…”

Section: Methodssupporting

confidence: 75%

The relationship between severe maternal morbidity and psychological health symptoms at 6–8 weeks postpartum: a prospective cohort study in one English maternity unit

Furuta

Sandall

Cooper

et al. 2014

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundThe incidence of severe maternal morbidity is increasing in high-income countries. However, little has been known about the impact on postnatal morbidity, particularly on psychological health outcomes. The objective of this study was to assess the relationship between severe maternal morbidity (ie. major obstetric haemorrhage, severe hypertensive disorders or intensive care unit/obstetric high dependency unit admission) and postnatal psychological health symptoms, focusing on post-traumatic stress disorder (PTSD) symptoms at 6–8 weeks postpartum.MethodA prospective cohort study was undertaken of women who gave birth over six months in 2010 in an inner city maternity unit in England. Primary outcomes were prevalence of PTSD symptoms namely: 1) intrusion and 2) avoidance as measured using the Impact of Event Scale at 6 – 8 weeks postpartum via a self-administered postal questionnaire. Secondary outcomes included probable depression. Data on incidence of severe maternal morbidity were extracted from maternity records. Multivariable logistic regression analysis examined the relationship between severe maternal morbidity and PTSD symptoms taking into account factors that might influence the relationship.ResultsOf women eligible to participate (n=3509), 52% responded. Prevalence of a clinically significant level of intrusion and avoidance were 6.4% (n=114) and 8.4% (n=150) respectively. There was a higher risk of PTSD symptoms among women who experienced severe maternal morbidity compared with women who did not (adjusted OR = 2.11, 95%CI = 1.17-3.78 for intrusion; adjusted OR = 3.28, 95%CI = 2.01-5.36 for avoidance). Higher ratings of reported sense of control during labour/birth partially mediated the risk of PTSD symptoms. There were no statistically significant differences in the prevalence or severity of symptoms of depression.ConclusionThis is one of the largest studies to date of PTSD symptoms among women who had recently given birth. Findings showed that an experience of severe maternal morbidity was independently associated with symptoms of PTSD. Individually tailored care that increases women’s sense of control during labour may be a protective factor with further work required to promote effective interventions to prevent these symptoms. Findings have important implications for women’s health and the content and organisation of maternity services during and after the birth.

show abstract

Section: Methodssupporting

confidence: 75%

The relationship between severe maternal morbidity and psychological health symptoms at 6–8 weeks postpartum: a prospective cohort study in one English maternity unit

Furuta

Sandall

Cooper

et al. 2014

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…Among nulliparous women, receiving medicinal pain relief explained the difference in sense of control during first stage of labour between women planning home and hospital birth. This could suggest that medicinal pain relief is in the causal pathway: women who plan a hospital birth more often receive medicinal pain relief (our results) and medicinal pain relief has been associated with a lower sense of control [19]. Women who planned a hospital birth but who gave birth at home, had a LAS-11 score similar to women who planned a home birth and who actually had a home birth.…”

Section: Discussionmentioning

confidence: 89%

“…Furthermore, we evaluated the effect of receiving medicinal pain relief (yes/no), because it might be a factor in the causal pathway of the association between planning a hospital birth [34], and sense of control [19]. In addition, anxiety during pregnancy, measured with the Pregnancy Related Anxiety Questionnaire-Revised version (PRAQ-R) score, was assessed as potential explanatory factor, in the relation between planned place of birth and sense of control.…”

Section: Methodsmentioning

confidence: 99%

Birth setting, transfer and maternal sense of control: results from the DELIVER study

Geerts

Klomp

Lagro-Janssen

et al. 2014

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundIn the Netherlands, low risk women receive midwife-led care and can choose to give birth at home or in hospital. There is concern that transfer of care during labour from midwife-led care to an obstetrician-led unit leads to negative birth experiences, in particular among those with planned home birth. In this study we compared sense of control, which is a major attribute of the childbirth experience, for women planning home compared to women planning hospital birth under midwife-led care. In particular, we studied sense of control among women who were transferred to obstetric-led care during labour according to planned place of birth: home versus hospital.MethodsWe used data from the prospective multicentre DELIVER (Data EersteLIjns VERloskunde) cohort-study, conducted in 2009 and 2010 in the Netherlands. Sense of control during labour was assessed 6 weeks after birth, using the short version of the Labour Agentry Scale (LAS-11). A higher LAS-11 score indicates a higher feeling of control. We considered a difference of a minimum of 5.5 points as clinically relevant.ResultsNulliparous- and parous women who planned a home birth had a 2.6 (95% CI 1.0, 4.3) and a 3.0 (1.6, 4.4) higher LAS score during first stage of labour respectively and during second stage a higher score of 2.8 (0.9, 4.7) and 2.3 (0.6, 4.0), compared with women who planned a hospital birth. Overall, women who were transferred experienced a lower sense of control than women who were not transferred. Parous women who planned a home birth and who were transferred had a 4.3 (0.2, 8.4) higher LAS score in 2nd stage, compared to those who planned a hospital birth and who were transferred.ConclusionWe found no clinically relevant differences in feelings of control among women who planned a home or hospital birth. Transfer of care during labour lowered feelings of control, but feelings of control were similar for transferred women who planned a home or hospital birth.As far as their expected sense of control is concerned, low risk women should be encouraged to give birth at the location of their preference.

show abstract

“…Research has confirmed that relaxed, confident women cope better with labor than anxious, tense women; they experience more satisfaction and less distress and pain. They also require less medical attention, in terms of epidural blocks, forceps, and augmentation, and are less prone to postnatal depression (Flint, 1993;Green, Coupland, & Kitzinger, 1990;Hodnett & Osborn, 1989;Mackey, 1995;Taylor & Copstick, 1985). Therefore, it is of utmost importance that in labor and delivery women receive professional caring that has meaning for them as childbearing women.…”

Section: Discussionmentioning

confidence: 98%

Empowerment or discouragement: Women's experience of caring and uncaring encounters during childbirth

Halldórsdóttir¹,

Karlsdóttir

1996

Health Care for Women International

123

105

View full text Add to dashboard Cite

The objective of this study was to explore the essential structure of caring and uncaring encounters with nurse-midwives and other health professionals during labor and delivery as perceived by women who have given birth. The phenomenological perspective of qualitative research theory guided the methodological approach to the study, in which true dialogues were entered into with 10 mothers in Akureyri and Reykjavik, Iceland. The overriding theme of the women's experience of caring and uncaring was "empowerment or discouragement." Within that theme, four major categories were identified: (a) the nurse-midwife perceived as caring--an indispensable companion on the journey through labor and delivery; (b) the woman's perception of the effects of the encounter with the caring nurse-midwife--the sense of being empowered; (c) the nurse-midwife perceived as uncaring--an unfortunate hindrance to a successful birth experience; (d) the woman's perception of the effects of the encounter with the uncaring nurse-midwife--the sense of being discouraged. Findings indicate that the nurse-midwife who satisfies a woman's need for professional caring during the birth experience is likely to be more effective in meeting nursing and midwifery care goals than the nurse-midwife who does not and is perceived as uncaring.

show abstract

Effects of continuous intrapartum professional support on childbirth outcomes

Cited by 121 publications

References 19 publications

The relationship between severe maternal morbidity and psychological health symptoms at 6–8 weeks postpartum: a prospective cohort study in one English maternity unit

The relationship between severe maternal morbidity and psychological health symptoms at 6–8 weeks postpartum: a prospective cohort study in one English maternity unit

Birth setting, transfer and maternal sense of control: results from the DELIVER study

Empowerment or discouragement: Women's experience of caring and uncaring encounters during childbirth

Contact Info

Product

Resources

About