Intrapartum Maternal Oxygen Supplementation—Friend or Foe?

Relationship Between Umbilical Cord Gas Values and Neonatal Outcomes

“…Normal labor is a process involving repetitive contraction-induced reductions of fetal oxygen delivery and has for decades been recognized as a process that is “invariably asphyxiating.” 20,26 This long-term hypoxic stress results in the development of significant metabolic acidemia, with a median pH value at the time of uncomplicated vaginal delivery of 7.25 (2.5th percentile 7.08.) 26 This pH reflects a level of hypoxia-induced acidemia, which would generally reflect critical illness in an adult. Although unique fetal hematologic characteristics retard the development of this acidemia during labor, the effect of acidemia per se is not affected by these changes, and a significant spectrum of fetal tolerance of such degrees of acidemia would be expected.…”

Category II Intrapartum Fetal Heart Rate Patterns Unassociated With Recognized Sentinel Events: Castles in the Air

“…4 We are not advocating for prophylactic BSO but for improved counseling about BSO for those scheduled for hysterectomy. As Cusimano et al 5 and others have concluded, after age 50 years, there is no increased risk of death with BSO. Although ovarian cancer is rare, we argue that, without increased risk after menopause, BSO at the time of hysterectomy will save some the unnecessary burden of ovarian cancer.…”

Current Resources for Evidence‐Based Practice, July/August 2021

“…The more effective verbal instruction to help a person achieve a pelvic floor contraction is "squeeze your anus." 20 An inability to perform a contraction or repeated Valsalva maneuvers with repeated instructions would be reason for referral to a specialist. Once someone is able to feel the contraction of the pelvic floor and perform its contraction correctly, they should be given a written prescription of 8-8-8-3-3-3: 8 contractions in a row, held for 8 seconds with 8 seconds of rest, 3 times a day, at least 3 days per week, for 3 months (lifelong ideally).…”

“…14 Pammi and colleagues argue in their editorial accompanying Raghuraman et al's metaanalysis that if we are serious about promoting evidencebased care, it is inappropriate to expose 2 to 3 million persons every year to supplemental oxygen. 20 As midwives, we err on the side of nonintervention unless there is evidence for intervention. The data so far support this approach; oxygen supplementation is not a needed step in in utero resuscitation.…”