Evaluating the content and quality of intrapartum care in vaginal births: An example of a state hospital

Abstract

Objective:The purpose of the research was to assess the content and quality of the intrapartum care offered in vaginal births in Turkey, based on the example of a state hospital.Materials and Methods:This cross-sectional study was conducted between January 1st, 2013 and December 31st, 2014 at Aydın Maternity and Children’s Hospital. The study sample consisted of 303 women giving vaginal birth, who were recruited into the study using the method of convenience sampling. Research data were collected with a questionnaire created by the researchers and assessed using the Bologna score. Numbers and percentages were assessed in the data analysis.Results:The mean age of the women was 25.14±5.37 years and 40.5% had given one live birth. Of the women, 45.2% were admitted to hospital in the latent phase, 76.6% were administered an enema, 3.3% had epidural anesthesia, 2.6% delivered using vacuum extraction, and 54.1% underwent an episiotomy. Some 23.8% of the women experienced spontaneous laceration that needed sutures. The babies of two women exhibited an Apgar score below 7 in the fifth minute. When the quality of the intrapartum care given to the women was assessed with the Bologna score, it was found that 92.7% went into labor spontaneously, 100% of the births were supervised by midwives and doctors, 97.7% of the women had no supporting companion, and the nonsupine position was only used in 0.3% of the women. A partogram was used to follow up on the birth process in 72.6% of the women, and 82.5% achieved contact with their babies within the first hour after birth. Induction was applied in 76.6% of the women and fundal pressure in 27.4%.Conclusion:The study revealed that the quality of intrapartum care in vaginal births was inadequate. Reformulating the guidelines regarding intrapartum care in accordance with World Health Organization recommendations and evidence-based practices may contribute to improving mother and infant health.

Evidence-based intrapartum care during vaginal births: Direct observations in a tertiary care hospital in Central Sri Lanka

“…It was seen in the present study that fundal pressure was applied to a significant percentage (19.9%) of women. However, this rate is lower than previously reported in several studies conducted in India (50.8%) [ 26 ], Turkey (43.3%) [ 41 ], Turkey (72.6%) [ 60 ], Egypt (36.0%) [ 30 ], Ethiopia (39.6%) [ 42 ] and the Philippines (31.2%) [ 19 ]. In many countries, care providers commonly practice fundal pressure during the second stage of labour to help expedite the delivery process and shorten the second stage of labour [ 30 , 61 ].…”

Women’s experience and satisfaction with midwife-led maternity care: a cross-sectional survey in China

“…In this study, the use of episiotomy was well controlled (23.2%), and the 3rd degree perineal laceration was very insignificant (2 cases out of 4192). This episiotomy rate is well below other countries, such as Turkey (54.1%) [ 40 ], Nepal (48.8%) [ 43 ], Austria (30.0–39.7%) [ 44 ]. It is interesting to note that our findings show no correlation between episiotomy or perineal laceration and labor satisfaction.…”

“…Kamakshi found that about 33% of the participants knew that delivery is possible without pain, but only 18% were satisfied with the procedure. In Turkey, epidural anesthesia rate for women who have vaginal deliveries is 3.3% [ 40 ]. While in the US, the rate is 60.7–83.5% [ 41 ].…”

Effect of Hypnobirthing Training on Fear, Pain, Satisfaction Related to Birth, and Birth Outcomes: A Randomized Controlled Trial

“…Similar findings can be found in the relevant literature (Swencionis et al, 2012). However, there are also dissimilar findings, and there are also studiesin which the pregnant women were transferred in to the delivery room early or went through labor in a room with many other women (Atis & Rathfisch, 2018; Karaçam et al, 2017). These different results are likely due to the difference between the standard care protocols adopted by the hospitals where the studies were conducted.…”