Influence on birthing positions affects women's sense of control in second stage of labour

Nieuwenhuijze, Marianne; Jonge, Ank de; Korstjens, Irene; Budé, Luc; Lagro‐Janssen, Toine

doi:10.1016/j.midw.2012.12.007

Cited by 54 publications

(49 citation statements)

References 50 publications

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“…Among the women who were transferred in our study, no clinically relevant differences were found either. The sense of control scores of women in second stage of labour in our study was higher (mean 58.6) than the LAS-11 reported in a Dutch study into the influence of birthing positions on sense of control during labour (mean 56.2) [40]. Nevertheless, the difference is small and not clinically relevant (< 5.5 points).…”

Section: Discussioncontrasting

confidence: 82%

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

Geerts

Klomp

Lagro-Janssen

et al. 2014

BMC Pregnancy Childbirth

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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.

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Section: Discussioncontrasting

confidence: 82%

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

Geerts

Klomp

Lagro-Janssen

et al. 2014

BMC Pregnancy Childbirth

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“…The possibility to change the position in labour might positively influence childbirth experience and also the good course and outcome of labour [24]. …”

Section: Discussionmentioning

confidence: 99%

Women’s Choice of Positions during Labour: Return to the Past or a Modern Way to Give Birth? A Cohort Study in Italy

Gizzo

Gangi

Noventa

et al. 2014

BioMed Research International

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Background. Childbirth medicalization has reduced the parturient's opportunity to labour and deliver in a spontaneous position, constricting her to assume the recumbent one. The aim of the study was to compare recumbent and alternative positions in terms of labour process, type of delivery, neonatal wellbeing, and intrapartum fetal head rotation. Methods. We conducted an observational cohort study on women at pregnancy term. Primiparous women with physiological pregnancies and single cephalic fetuses were eligible for the study. We considered data about maternal-general characteristics, labour process, type of delivery, and neonatal wellbeing at birth. Patients were divided into two groups: Group-A if they spent more than 50% of labour in a recumbent position and Group-B when in alternative ones. Results. 225 women were recruited (69 in Group-A and 156 in Group-B). We found significant differences between the groups in terms of labour length, Numeric Rating Scale score and analgesia request rate, type of delivery, need of episiotomy, and fetal occiput rotation. No differences were found in terms of neonatal outcomes. Conclusion. Alternative maternal positioning may positively influence labour process reducing maternal pain, operative vaginal delivery, caesarean section, and episiotomy rate. Women should be encouraged to move and deliver in the most comfortable position.

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“…Other researchers have indicated that the ability to change positions and women's ability to determine which positions are used affect their satisfaction with the birth experience and sense of control . Currently, there is no evidence that one specific position is optimal.…”

Section: Introductionmentioning

confidence: 99%

The Role of Maternity Care Providers in Promoting Shared Decision Making Regarding Birthing Positions During the Second Stage of Labor

Nieuwenhuijze¹,

Low²,

Korstjens³

et al. 2014

J Midwife Womens Health

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Introduction Through the use of a variety of birthing positions during second stage labor, a woman can increase progress, improve outcomes, and have a positive birth experience. The role maternity care providers play in determining which position a woman uses during second stage has not been thoroughly explored. The purpose of this qualitative investigation was to explore how maternity care providers communicate with women during second stage labor regarding birthing position. Methods A literature informed framework was developed to conduct a process of deductive content analysis of communication patterns between nulliparous women and their maternity care providers during second stage. Literature regarding shared decision making, control, and predictors of positive birth experiences were reviewed to develop a coding framework. The framework included the following categories: listening to women, encouragement, information, offering choices and style of support. Forty-one audio tapes of women and their maternity care providers during second stage labor were transcribed verbatim and analyzed. Results Themes identified in the transcripts included all those in the analytic framework plus two added categories of communication: empathy and interaction. Maternity care providers in this study enabled women to select various birthing positions using a dynamic process that moved between open, informative approaches and more closed, directive approaches depending on the woman's needs and clinical condition. Women became more actively involved in shared decision making regarding birthing positions as providers found the right balance between being responsive to the woman's questions or directive as clinical conditions unfolded. Discussion Enabling shared decision making during birth is not a linear process using a single approach; it is dynamic process that requires a variety of approaches. Care providers can support a woman to use different birthing positions during second stage labor by employing a flexible style that incorporates clinical assessment and the woman's responses.

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Influence on birthing positions affects women's sense of control in second stage of labour

Cited by 54 publications

References 50 publications

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

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

Women’s Choice of Positions during Labour: Return to the Past or a Modern Way to Give Birth? A Cohort Study in Italy

The Role of Maternity Care Providers in Promoting Shared Decision Making Regarding Birthing Positions During the Second Stage of Labor

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