The initiation of labour at term gestation: Physiology and practice implications

Hundley, Vanora; Downe, Soo; Buckley, Sarah J.

doi:10.1016/j.bpobgyn.2020.02.006

Cited by 15 publications

(6 citation statements)

References 62 publications

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“…In another study in Tanzania, mothers also reported mistreatment, failure to meet professional standards of care, poor rapport between women and providers. 14 HPs respectful and appropriate attitudes towards mothers are essential to ensure the quality of child-birth experience; 15 but systematic reviews on maternity services quality, all over the world, have also shown a widespread occurrence of different forms of mistreatment of women during delivery, impacting negatively on both clinical and psychological outcomes, and also poor staff knowledge and skills. 16 Our evaluation reveals no signi cant impact of HPs trainings on maternity attendance quality.…”

Section: Discussionmentioning

confidence: 99%

An Analysis of the Quality of Maternity Services in Nampula, Mozambique.

Pires¹,

Mupueleque²,

Mucufo³

et al. 2020

Preprint

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BackgroundMaternity service quality is essential to reduce maternal and new-born morbidity and mortality (extremely high in Africa, including Mozambique). In Mozambique, maternal mortality rate is 451.6 maternal deaths per 100000 live births (2017). The reasons for this are complex, but one important factor to reduce this burden is ensuring the quality of maternity services, with the availability of efficient care, to improve institutional deliveries. To contribute to reduce maternal and new-born mortality rates in Natikiri, Nampula, the Lúrio University and the University of Saskatchewan, carried out an implementation research, including training activities for health professionals in maternal and child health care. We planned a mid-project evaluation, to assess the impact of the trainings, on the quality of services at Marrere Hospital Maternity.MethodsQuantitative pre-post study, applying two cross-sectional surveys about maternity service quality, one of the surveys being conducted after five health professionals’ trainings and the other after six more trainings. The two surveys included samples of post-partum women in the maternity, calculated with a 10% margin error and 90% confidence interval for the first survey, and with a 7% margin error and 95% confidence interval for the second. The surveys were entered into REDCap and analysed to assess frequency, percentage, mean and standard deviation. This research was approved by the Institutional Committees of Bioethics at Lúrio University and at the University of Saskatchewan.Results116 post-partum women were surveyed at the maternity, assessing standards of patient centred care during delivery labour. Most areas showed no improvement. Some positive improvements were: delivering women were given the option to have a person of their choice to accompany them during labour (75%), notably a traditional birth attendant (34%), and they had continuous support from an health professional (68%). But many shortcomings persisted in areas of privacy (33%), and confidentiality (57%). ConclusionThe quality of patient centred care at Marrere General Hospital Maternity, did not improve with health professionals training. Decreasing the large turnover rate, and reviewing health professionals learning styles, promoting continuous professional capacity building, would be the next steps to improve quality of patient centred care.Trial registrationThis study was not registered in any data base.

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Section: Discussionmentioning

confidence: 99%

An Analysis of the Quality of Maternity Services in Nampula, Mozambique.

Pires¹,

Mupueleque²,

Mucufo³

et al. 2020

Preprint

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“…In low-risk pregnancies without a recognized indication for labour induction women may prefer to avoid induction of labour and try alternative methods to start labour spontaneously instead of or as well as medical induction. Non-clinical methods women may try include sexual intercourse, nipple stimulation, acupuncture and acupressure, raspberry leaf tea, physical activity, various foods and herbal preparations (30). Many of these approaches are likely to have no negative impact on the woman and her baby besides the known risk of prolonging pregnancy beyond a certain gestational age, although it is important to know that some herbal preparations have been associated with adverse effects, and there is no good quality evidence of safety (30,31).…”

Section: Views On Alternatives To Induction Of Labourmentioning

confidence: 99%

“…Non-clinical methods women may try include sexual intercourse, nipple stimulation, acupuncture and acupressure, raspberry leaf tea, physical activity, various foods and herbal preparations (30). Many of these approaches are likely to have no negative impact on the woman and her baby besides the known risk of prolonging pregnancy beyond a certain gestational age, although it is important to know that some herbal preparations have been associated with adverse effects, and there is no good quality evidence of safety (30,31). Women do want to have discussions about alternatives to induction of labour (4,25) and for the purposes of informing women about alternative methods, systematic reviews suggest that acupuncture and acupressure do not make a difference to the likelihood of medical IoL being required (32), but there is no review level evidence for other complementary therapies (33).…”

Section: Views On Alternatives To Induction Of Labourmentioning

confidence: 99%

Attitudes of pregnant women and healthcare professionals to labour induction and obtaining consent for labour induction

Coates

2021

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…Although the onset of labour is not a fully understood phenomenon, it is likely triggered by interactive, finely coordinated anatomical and neurohormonal processes 1 2. The result is that spontaneous labour onset in healthy, pregnant women at term usually occurs when both the mother and baby are at peak biophysical, neurohormonal and psychological readiness for birth and maternal–newborn transitions 2 3.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between prelabour caesarean section and perinatal outcomes: analysis of demographic and health surveys from 26 low-income and middle-income countries

Opiyo

Bellizzi²,

Torloni

et al. 2022

BMJ Open

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ObjectivesCaesarean section (CS) conducted before labour (prelabour CS (PLCS)), compared with vaginal birth, may pose additional maternal and perinatal risks. No multicountry analysis has examined PLCS in low-income and middle-income countries (LMICs). This study assessed rates, risk factors and associations of PLCS with perinatal outcomes in LMICs.DesignPopulation-based cross-sectional surveys.SettingDemographic and Health Surveys conducted between 2015 and 2018 in 26 LMICs (13 countries in Africa, 11 in Asia and 2 in the Americas).ParticipantsWomen aged 15–49 years with singleton term births.Outcome measuresMain outcomes were early neonatal mortality, neonatal mortality, early breastfeeding (within 1 hour of birth), skin-to-skin contact and duration of hospital stay.Results255 227 women were included in the main analysis. Average rates of primary PLCS ranged from 1.3% in Zambia to 19.5% in Maldives. Median PLCS rate was 1.8% in the poorest versus 5.8% in the richest subgroups.Higher maternal age, education, economic status and BMI, lower parity, urban residence, delivery in private hospitals, larger baby size, having health insurance, more antenatal care (ANC) visits, ANC by a doctor and ANC in private hospitals were associated with increased primary PLCS.Across the 26 countries, primary PLCS, compared with vaginal delivery, was associated with increased neonatal mortality (adjusted odds ratio, aOR 1.2, 95% CI 1.0 to 1.5), decreased early breastfeeding (aOR 0.4, 95% CI 0.3 to 0.5) and skin-to-skin contact (aOR 0.4, 95% CI 0.3 to 0.5) and longer hospital stay (aOR 6.6, 95% CI 5.9 to 7.4). No significant association was found for early neonatal mortality (aOR 1.2, 95% CI 0.9 to 1.5).ConclusionPrimary PLCS, compared with vaginal birth, is associated with adverse perinatal outcomes in singleton term pregnancies in LMICs. Caesarean births should be audited regularly to monitor trends, appropriateness and context-specific drivers of CS.

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The initiation of labour at term gestation: Physiology and practice implications

Cited by 15 publications

References 62 publications

An Analysis of the Quality of Maternity Services in Nampula, Mozambique.

An Analysis of the Quality of Maternity Services in Nampula, Mozambique.

Attitudes of pregnant women and healthcare professionals to labour induction and obtaining consent for labour induction

Association between prelabour caesarean section and perinatal outcomes: analysis of demographic and health surveys from 26 low-income and middle-income countries

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