Files and links (2)
Factors associated with spontaneous vaginal birth in nulliparous women A descriptive systematic review1.45 MB
Published VersionCC BY V4.0, Open Access
Journal article
Factors associated with spontaneous vaginal birth in nulliparous women: A descriptive systematic review
Women and Birth, Vol.37(1), pp.63-78
2024
Abstract
Problem: Spontaneous vaginal birth (SVB) rates for nulliparous women are declining internationally. Background: There is inadequate understanding of factors affecting this trend overall and limited large-scale responses to improve women's opportunity to birth spontaneously. Aim: To undertake a descriptive systematic review identifying factors associated with spontaneous vaginal birth at term, in nulliparous women with a singleton pregnancy. Methods: Quantitative studies of all designs, of nulliparous women with a singleton pregnancy and cephalic presentation, who experienced a SVB at term were included. Nine databases were searched (inception to October 2022). Two reviewers undertook quality appraisal; Randomised Controlled Trials (RCTs) with high risk of bias (ROB 2.0) and other designs with (QATSDD) scoring ≤ 50% were excluded. Findings: Data were abstracted from 90 studies (32 RCTs, 39 cohort, 9 cross-sectional, 4 prevalence, 5 case control, 1 quasi-experimental). SVB rates varied (13% 99%). Modifiable factors associated with SVB included addressing fear of childbirth, low impact antenatal exercise, maternal positioning during second-stage labour and midwifery led care. Complexities arising during pregnancy and regional analgesia were shown to decrease SVB and other interventions, such as routine induction of labour were equivocal. Discussion: Antenatal preparation (low impact exercise, childbirth education, addressing fear of childbirth) may increase SVB, as does midwifery continuity-of-care. Intrapartum strategies to optimise labour progression emerged as promising areas for further research. Conclusion: Declining SVB rates may be improved through multi-factorial approaches inclusive of maternal, fetal and clinical care domains. However, the variability of SVB rates testifies to the complexity of the issue.
Details
- Title
- Factors associated with spontaneous vaginal birth in nulliparous women: A descriptive systematic review
- Authors
- Lauren Kearney (Author) - The University of QueenslandRachael Nugent (Author) - Sunshine Coast Hospital and Health ServiceJane Maher (Author) - Sunshine Coast University Hospital (Australia)Rebecca Shipstone (Author) - University of the Sunshine Coast, Queensland, School of Health - NursingJohn M D Thompson (Author) - University of the Sunshine Coast, Queensland, School of Health - NursingRachel Boulton (Author) - Sunshine Coast Hospital and Health ServiceKendall George (Author) - Townsville HospitalAnna Robins (Author) - University of the Sunshine Coast, Queensland, School of Health - MidwiferyFiona Bogossian (Author) - University of the Sunshine Coast, Queensland, School of Health
- Publication details
- Women and Birth, Vol.37(1), pp.63-78
- Publisher
- Elsevier BV
- Date published
- 2024
- DOI
- 10.1016/j.wombi.2023.08.009
- ISSN
- 1878-1799; 1871-5192
- Copyright note
- This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
- Organisation Unit
- School of Health; School of Health - Nursing; University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy; School of Health and Behavioural Sciences - Legacy; School of Health - Midwifery
- Language
- English
- Record Identifier
- 99966895702621
- Output Type
- Journal article
Metrics
4 File views/ downloads
41 Record Views