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A critique of the literature on women's request for cesarean section
Women and Birth (2008) 21, 92—93
a v a i l a b l e a t w w w. s c i e n c e d i r e c t . c o m
journal homepage: www.elsevier.com/locate/wombi
AUSTRALIAN RESEARCH: ABSTRACTS OF INTEREST
If you have published in another journal and would like your abstract considered for publication in Women and Birth please contact Jennifer Fenwick ([email protected]).
A critique of the literature on women’s request for cesarean section
Perineal outcomes and maternal comfort related to the application of perineal warm packs in the second stage of labor: A randomized controlled trial
This article was published in Birth, 34(4), Gamble, J., Creedy, D.K., McCourt, C., Weaver, J., & Beake, S. A critique of the literature on women’s request for cesarean section. pp. 331— 340. Copyright Blackwell Publishing, Inc.
This article was published in Birth, 34(4), Dahlen, H.G., Homer, S.C.E., Cooke, M., Upton, A.M., Brodrick, B., & Nunn, R. Perineal outcomes and maternal comfort related to the application of perineal warm packs in the second stage of labor: A randomized controlled trial. pp. 282—290. Copyright Blackwell Publishing, Inc. Background. Perineal warm packs are widely used during childbirth in the belief that they reduce perineal trauma and increase comfort during late second stage of labor. The aim of this study was to determine the effects of applying warm packs to the perineum on perineal trauma and maternal comfort during the late second stage of labor. Methods. A randomized controlled trial was undertaken. In the late second stage of labor, nulliparous women (n = 717) giving birth were randomly allocated to have warm packs (n = 360) applied to their perineum or to receive standard care (n = 357). Standard care was defined as any second-stage practice carried out by midwives that did not include the application of warm packs to the perineum. Analysis was on an intention-to-treat basis, and the primary outcome measures were requirement for perineal suturing and maternal comfort. Results. The difference in the number of women who required suturing after birth was not significant. Women in the warm pack group had significantly fewer third- and fourthdegree tears and they had significantly lower perineal pain scores when giving birth and on ‘‘day 1’’ and ‘‘day 2’’ after the birth compared with the standard care group. At 3 months, they were significantly less likely to have urinary incontinence compared with women in the standard care group.Conclusions. The application of perineal warm packs in late second stage does not reduce the likelihood of nulliparous women requiring perineal suturing but significantly reduces third- and fourth-degree lacerations, pain during the birth and on days 1 and 2, and urinary incontinence. This simple, inexpensive practice should be incorporated into second stage labor care. doi: 10.1016/j.wombi.2008.03.002 1871-5192/$ — see front matter
Background. The influence of women’s birth preferences on the rising caesarean section rates is uncertain and possibly changing. This review of publications relating to women’s request for cesarean delivery explores assumptions related to the social, cultural, and political-economic contexts of maternity care and decision-making. Method. A search of major databases was undertaken using the following terms: ‘‘c(a)esarean section’’ with ‘‘maternal request’’, ‘‘decisionmaking’’, ‘‘patient participation’’, ‘‘decision-making-patient’’, ‘‘patient satisfaction’’, ‘‘patient preference’’, ‘‘maternal choice’’, ‘‘on demand’’, and ‘‘consumer demand’’. Seventeen papers examining women’s preferred type of birth were retrieved. Results. No studies systematically examined information provided to women by health professionals to inform their decision. Some studies did not adequately acknowledge the influence of obstetric and psychological factors in relation to women’s request for a cesarean section. Other potential influences were poorly addressed, including whether or not the doctor advised a vaginal birth, women’s access to midwifery care in pregnancy, information provision, quality of care, and cultural issues. Discussion. The psychosocial context of obstetric care reveals a power imbalance in favor of physicians. Research into decision-making about cesarean section that does not account for the way care is offered, observe interactions between women and practitioners, and analyze the context of care should be interpreted with caution. doi: 10.1016/j.wombi.2008.03.003
a v a i l a b l e a t w w w. s c i e n c e d i r e c t . c o m
journal homepage: www.elsevier.com/locate/wombi
AUSTRALIAN RESEARCH: ABSTRACTS OF INTEREST
If you have published in another journal and would like your abstract considered for publication in Women and Birth please contact Jennifer Fenwick ([email protected]).
A critique of the literature on women’s request for cesarean section
Perineal outcomes and maternal comfort related to the application of perineal warm packs in the second stage of labor: A randomized controlled trial
This article was published in Birth, 34(4), Gamble, J., Creedy, D.K., McCourt, C., Weaver, J., & Beake, S. A critique of the literature on women’s request for cesarean section. pp. 331— 340. Copyright Blackwell Publishing, Inc.
This article was published in Birth, 34(4), Dahlen, H.G., Homer, S.C.E., Cooke, M., Upton, A.M., Brodrick, B., & Nunn, R. Perineal outcomes and maternal comfort related to the application of perineal warm packs in the second stage of labor: A randomized controlled trial. pp. 282—290. Copyright Blackwell Publishing, Inc. Background. Perineal warm packs are widely used during childbirth in the belief that they reduce perineal trauma and increase comfort during late second stage of labor. The aim of this study was to determine the effects of applying warm packs to the perineum on perineal trauma and maternal comfort during the late second stage of labor. Methods. A randomized controlled trial was undertaken. In the late second stage of labor, nulliparous women (n = 717) giving birth were randomly allocated to have warm packs (n = 360) applied to their perineum or to receive standard care (n = 357). Standard care was defined as any second-stage practice carried out by midwives that did not include the application of warm packs to the perineum. Analysis was on an intention-to-treat basis, and the primary outcome measures were requirement for perineal suturing and maternal comfort. Results. The difference in the number of women who required suturing after birth was not significant. Women in the warm pack group had significantly fewer third- and fourthdegree tears and they had significantly lower perineal pain scores when giving birth and on ‘‘day 1’’ and ‘‘day 2’’ after the birth compared with the standard care group. At 3 months, they were significantly less likely to have urinary incontinence compared with women in the standard care group.Conclusions. The application of perineal warm packs in late second stage does not reduce the likelihood of nulliparous women requiring perineal suturing but significantly reduces third- and fourth-degree lacerations, pain during the birth and on days 1 and 2, and urinary incontinence. This simple, inexpensive practice should be incorporated into second stage labor care. doi: 10.1016/j.wombi.2008.03.002 1871-5192/$ — see front matter
Background. The influence of women’s birth preferences on the rising caesarean section rates is uncertain and possibly changing. This review of publications relating to women’s request for cesarean delivery explores assumptions related to the social, cultural, and political-economic contexts of maternity care and decision-making. Method. A search of major databases was undertaken using the following terms: ‘‘c(a)esarean section’’ with ‘‘maternal request’’, ‘‘decisionmaking’’, ‘‘patient participation’’, ‘‘decision-making-patient’’, ‘‘patient satisfaction’’, ‘‘patient preference’’, ‘‘maternal choice’’, ‘‘on demand’’, and ‘‘consumer demand’’. Seventeen papers examining women’s preferred type of birth were retrieved. Results. No studies systematically examined information provided to women by health professionals to inform their decision. Some studies did not adequately acknowledge the influence of obstetric and psychological factors in relation to women’s request for a cesarean section. Other potential influences were poorly addressed, including whether or not the doctor advised a vaginal birth, women’s access to midwifery care in pregnancy, information provision, quality of care, and cultural issues. Discussion. The psychosocial context of obstetric care reveals a power imbalance in favor of physicians. Research into decision-making about cesarean section that does not account for the way care is offered, observe interactions between women and practitioners, and analyze the context of care should be interpreted with caution. doi: 10.1016/j.wombi.2008.03.003