Journal article
Maternal Position at Midwife Attended Birth and Perineal Trauma: Is There an Association?
Birth: issues in perinatal care, Vol.32(3), pp.164-169
2005
Abstract
Most women will sustain some degree of trauma to the genital tract after vaginal birth. This study aimed to examine the association between maternal position at birth and perineal outcome in women who had a midwifeattended, spontaneous vaginal birth and an uncomplicated pregnancy at term. Data from 3,756 births in a major public tertiary teaching hospital were eligible for analysis. The need for sutures in perineal trauma was evaluated and compared for each major factor studied (maternal age, first vaginal delivery, induction of labor, not occipitoanterior, use of regional anesthesia, deflexed head and newborn birthweight greater than 3,500 g). Birth positions were compared against each other. Subgroup analysis determined whether birth positions mattered more or less in each of the major factors studied. The chisquare test was used to compare categorical variables. Most women (65.9%) gave birth in the semirecumbent position. Of the 1,679 women (44.5%) who required perineal suturing, semirecumbent position was associated with the need for perineal sutures, whereas allfours was associated with reduced need for sutures; these associations were more marked in first vaginal births and newborn birth weight over 3,500 g. When regional anesthesia was used, semirecumbent position was associated with a need for suturing, and lateral position associated with a reduced need for suturing. The four major factors significantly related to perineal trauma included first vaginal birth, use of regional anesthesia, deflexed head, and newborn weight more than 3,500 g. Women should be given the choice to give birth in whatever position they find comfortable. Maternity practitioners have a responsibility to inform women of the likelihood of perineal trauma in the preferred birth position. Ongoing audit of all clinicians attending births is encouraged to further determine effects of maternal birth position and perineal trauma, to investigate women's perception of comfortable positioning at birth, and to measure changes to midwifery practice resulting from this study.
Details
- Title
- Maternal Position at Midwife Attended Birth and Perineal Trauma: Is There an Association?
- Authors
- B Soong (Author) - Mater Mothers HospitalMargaret Barnes (Author) - Queensland University of Technology
- Publication details
- Birth: issues in perinatal care, Vol.32(3), pp.164-169
- Publisher
- Blackwell Publishing Inc.
- DOI
- 10.1111/j.0730-7659.2005.00365.x
- ISSN
- 0730-7659
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy
- Language
- English
- Record Identifier
- 99450152102621
- Output Type
- Journal article
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- Web Of Science research areas
- Nursing
- Obstetrics & Gynecology
- Pediatrics
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Source: InCites