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American Family Physician Jun 2021Since the 1970s, most births in the United States have been planned to occur in a hospital. However, a small percentage of Americans choose to give birth outside of a... (Review)
Review
Since the 1970s, most births in the United States have been planned to occur in a hospital. However, a small percentage of Americans choose to give birth outside of a hospital. The number of out-of-hospital births has increased, with one in every 61 U.S. births (1.64%) occurring out of the hospital in 2018. Out-of-hospital (or community) birth can be planned or unplanned. Of those that are planned, most occur at home and are assisted by midwives. Patients who choose a planned community birth do so for multiple reasons. International observational studies that demonstrate comparable outcomes between planned out-of-hospital and planned hospital birth may not be generalizable to the United States. Most U.S. studies have found statistically significant increases in perinatal mortality and neonatal morbidity for home birth compared with hospital birth. Conversely, planned community birth is associated with decreased odds of obstetric interventions, including cesarean delivery. Perinatal outcomes for community birth may be improved with appropriate selection of low-risk, vertex, singleton, term pregnancies in patients who have not had a previous cesarean delivery. A qualified, licensed maternal and newborn health professional who is integrated into a maternity health care system should attend all planned community births. Family physicians are uniquely poised to provide counseling to patients and their families about the risks and benefits associated with community birth, and they may be the first physicians to evaluate and treat newborns delivered outside of a hospital.
Topics: Birth Setting; Birthing Centers; Female; Home Childbirth; Humans; Infant, Newborn; Midwifery; Patient Participation; Patient Safety; Patient Selection; Perinatal Care; Practice Guidelines as Topic; Pregnancy; Risk Assessment; United States
PubMed: 34060788
DOI: No ID Found -
PloS One 2020Psychological aspects of labor and birth have received little attention within maternity care service planning or clinical practice. The aim of this paper is to propose... (Review)
Review
BACKGROUND
Psychological aspects of labor and birth have received little attention within maternity care service planning or clinical practice. The aim of this paper is to propose a model demonstrating how neurohormonal processes, in particular oxytocinergic mechanisms, not only control the physiological aspects of labor and birth, but also contribute to the subjective psychological experiences of birth. In addition, sensory information from the uterus as well as the external environment might influence these neurohormonal processes thereby influencing the progress of labor and the experience of birth.
METHODOLOGY
In this new model of childbirth, we integrated the findings from two previous systematic reviews, one on maternal plasma levels of oxytocin during physiological childbirth and one meta-synthesis of women´s subjective experiences of physiological childbirth.
FINDINGS
The neurobiological processes induced by the release of endogenous oxytocin during birth influence maternal behaviour and feelings in connection with birth in order to facilitate birth. The psychological experiences during birth may promote an optimal transition to motherhood. The spontaneous altered state of consciousness, that some women experience, may well be a hallmark of physiological childbirth in humans. The data also highlights the crucial role of one-to-one support during labor and birth. The physiological importance of social support to reduce labor stress and pain necessitates a reconsideration of many aspects of modern maternity care.
CONCLUSION
By listening to women's experiences and by observing women during childbirth, factors that contribute to an optimized process of labor, such as the mothers' wellbeing and feelings of safety, may be identified. These observations support the integrative role of endogenous oxytocin in coordinating the neuroendocrine, psychological and physiological aspects of labor and birth, including oxytocin mediated. decrease of pain, fear and stress, support the need for midwifery one-to-one support in labour as well as the need for maternity care that optimizes the function of these neuroendocrine processes even when birth interventions are used. Women and their partners would benefit from understanding the crucial role that endogenous oxytocin plays in the psychological and neuroendocrinological process of labor.
Topics: Female; Humans; Labor, Obstetric; Maternal Behavior; Maternal Health Services; Midwifery; Models, Biological; Oxytocin; Parturition; Postpartum Period; Pregnancy; Social Support; Stress, Physiological
PubMed: 32722725
DOI: 10.1371/journal.pone.0230992 -
European Journal of Obstetrics,... Jan 2017This review aims to examine how childbirth position during labour affects maternal, fetal and neonatal outcomes. Epidemiological data suggest that vertical birthing... (Review)
Review
This review aims to examine how childbirth position during labour affects maternal, fetal and neonatal outcomes. Epidemiological data suggest that vertical birthing positions have many benefits. But when we consider the players and mechanisms of delivery, including the forces generated to move the fetus and obstacles to its progression, many questions remain about the advantage of one position over another. Thus, childbirth could be considered in a way as an athletic feat that probably requires the choice of optimal positions. These should be individually suited to each woman at different stage of labour to improve its efficiency and effectiveness. Tweetable abstract: Beyond epidemiological data, biomechanical investigations is necessary to assess birth's position.
Topics: Adult; Biomechanical Phenomena; Cervical Ripening; Evidence-Based Medicine; Female; Humans; Infant, Newborn; Labor Presentation; Labor, Obstetric; Models, Biological; Parturition; Patient Positioning; Precision Medicine; Pregnancy; Pregnancy Outcome; Uterine Contraction
PubMed: 27888706
DOI: 10.1016/j.ejogrb.2016.11.006 -
American Journal of Obstetrics and... May 2023The first written guide for birth plans was introduced in 1980 as a means for birthing people to document their choices in the child birthing experience. The birth plan... (Review)
Review
The first written guide for birth plans was introduced in 1980 as a means for birthing people to document their choices in the child birthing experience. The birth plan offers an opportunity for the patient and the provider to discuss the birthing process and determine how to safely accommodate patient preferences. Patient satisfaction with birthing plans is variable and may depend on how many requests they have, how many of their plans are accomplished, route of delivery, and whether complications arise during or after delivery. Unmet expectations may lead to posttraumatic stress disorder, but following a birth plan may also be protective against it. Birthing people who use a birth plan may be less likely to use epidural anesthesia, have early amniotomy, or use oxytocin. The first stage of labor may be longer when a birth plan is used; however, there does not seem to be a decrease in the length of the second stage of labor among patients with a birth plan. Some providers believe that a disadvantage of birth plans is disappointment when birth plans are not able to be followed, and others consider that birth plans interfere with professional autonomy.
Topics: Pregnancy; Female; Child; Humans; Parturition; Labor, Obstetric; Prenatal Care; Amniotomy; Patient Satisfaction
PubMed: 37164502
DOI: 10.1016/j.ajog.2022.12.011 -
BMC Pregnancy and Childbirth Dec 2019It is believed that giving birth in an upright position is beneficial for both mother and the infant for several physiologic reasons. An upright positioning helps the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
It is believed that giving birth in an upright position is beneficial for both mother and the infant for several physiologic reasons. An upright positioning helps the uterus to contract more strongly and efficiently, the baby gets in a better position and thus can pass through the pelvis faster. Upright and lateral positions enables flexibility in the pelvis and facilitates the extension of the outlet. Before implementing a change in birthing positions in our clinics we need to review evidences available and context valid related to duration of second stage of labor and birthing positions. Therefore this review aimed to examine the effect of maternal flexible sacrum birth position on duration of second stage of labor.
METHOD
The research searched articles using bibliographical Databases: Medline/PUBMED, SCOPUS, Google scholar and Google. All study designs were considered while investigating the impact of maternal flexible sacrum birthing positioning in relation duration of second stage of labor. Studies including laboring mothers with normal labor and delivery. A total of 1985 women were included in the reviewed studies. We included both qualitative and quantitative analysis.
RESULTS
We identified 1680 potential citations, of which 8 articles assessed the effect of maternal upright birth positioning on the reduction during the duration of second stage of labor. Two studies were excluded because of incomplete reports for meta analysis. The result suggested a reduction in duration of second stage of labor among women in a flexible sacrum birthing position, with a mean duration from 3.2-34.8. The pooled weighted mean difference with random effect model was 21.118(CI: 11.839-30.396) minutes, with the same significant heterogeneity between the studies (I = 96.8%, p < 000).
CONCLUSION
The second stage duration was reduced in cases of a flexible sacrum birthing position. Even though the reduction in duration varies across studies with considerable heterogeneity, laboring women should be encouraged to choose her comfortable birth position. Researchers who aim to compare different birthing positions should consider study designs which enable women to choose birthing position. PROSPERO REGISTRATION NUMBER: [CRD42019120618].
Topics: Female; Humans; Labor Stage, Second; Parturition; Patient Positioning; Posture; Pregnancy; Sacrum; Time Factors
PubMed: 31801479
DOI: 10.1186/s12884-019-2620-0 -
Journal of Clinical Nursing Sep 2020This article explores the literature on women's expectations for birth, the sociocultural context from which these expectations originate and their impact on the... (Review)
Review
AIM
This article explores the literature on women's expectations for birth, the sociocultural context from which these expectations originate and their impact on the interpretation of birth experience.
BACKGROUND
Childbirth is associated with specific expectations from women with the potential for dissatisfaction if these expectations are not met.
DESIGN
This paper presents a systematic analysis of the concept of vulnerability in childbirth.
FINDINGS
A framework was extracted from the literature that linked the themes of a discourse of control, construction of inadequacy and shame of exposure to explain the sociocultural origin of dominant childbirth expectations in the literature. The experience of vulnerability unique to the birthing event is suggested as exposing the woman to this underlying contextual framework and impacting the interpretation of her birth.
CONCLUSION
This synthesis has exposed the transient experience of vulnerability during birth as a significant contributor to the birthing woman's interpretation of the birth and her place within it.
RELEVANCE TO CLINICAL PRACTICE
An explanatory framework is offered to clinicians that could increase their awareness of sociocultural and historical factors impacting a woman's expectations for birth. Appreciation of the woman's vulnerability in birth, exposing her to the influence of this framework, can assist clinicians to facilitate a quality birth experience for women. Furthermore, supporting women and midwives to accept this experience of birth vulnerability as a "negative capability," can facilitate an empowering birth experience.
Topics: Adult; Delivery, Obstetric; Fear; Female; Humans; Midwifery; Parturition; Pregnancy
PubMed: 32045047
DOI: 10.1111/jocn.15205 -
PloS One 2019Concern has been expressed globally over rising caesarean birth rates. Recently, the International Federation of Gynaecology and Obstetrics (FIGO) called for help from... (Review)
Review
Concern has been expressed globally over rising caesarean birth rates. Recently, the International Federation of Gynaecology and Obstetrics (FIGO) called for help from governmental bodies, professional organisations, women's groups, and other stakeholders to reduce unnecessary caesareans. As part of a wider research initiative, we conducted an overview of systematic reviews of antenatal and intrapartum interventions, and reports of evidence based recommendations, to identify and highlight those that have been shown to be effective for reducing caesarean birth, promoting vaginal birth and reducing fear of childbirth. Following registration of the review protocol, (PROSPERO 2018 CRD42018090681), we searched The Cochrane Database of Systematic Reviews, PubMed, CINAHL and EMBASE (Jan 2000-Jan 2018) and searched for grey literature in PROSPERO, and on websites of health professional and other relevant bodies. Screening and selection of reviews, quality appraisal using AMSTAR-2, and data extraction were performed independently by pairs of at least two reviewers. Excluding reviews assessed as 'critically low' on AMSTAR-2 (n = 54), 101 systematic reviews, and 10 reports of evidence based recommendations were included in the overview. Narrative synthesis was performed, due to heterogeneity of review methodology and topics. The results highlight twenty-five interventions, across 17 reviews, that reduced the risk of caesarean, nine interventions across eight reviews that increased the risk of caesarean, eight interventions that reduced instrumental vaginal birth, four interventions that increased spontaneous vaginal birth, and two interventions that reduced fear of childbirth. This overview of reviews identifies and highlights interventions that have been shown to be effective for reducing caesarean birth, promoting vaginal births and reducing fear of childbirth. In recognising that clinical practices change over time, this overview includes reviews published from 2000 onwards only, thus providing contemporary evidence, and a valuable resource for clinicians when making decisions on practices that should be implemented for reducing unnecessary caesarean births safely. Protocol Registration: PROSPERO 2018 CRD42018090681. Available from: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018090681.
Topics: Cesarean Section; Fear; Female; Humans; Parturition; Prenatal Care; Systematic Reviews as Topic
PubMed: 31648289
DOI: 10.1371/journal.pone.0224313 -
Placenta Dec 2020Preterm birth is a serious global health problem that affects 5-18% of pregnancies worldwide. In addition to being the major cause of neonatal mortality and morbidity,... (Review)
Review
Preterm birth is a serious global health problem that affects 5-18% of pregnancies worldwide. In addition to being the major cause of neonatal mortality and morbidity, preterm birth is associated with short term and long term complications in the offspring. Despite this, the causes and pathogenesis of preterm birth remain unclear. Neutrophils are innate immune cells that infiltrate the maternal-fetal interface during normal parturition and their accumulation is dramatically increased during preterm birth, especially in the presence of an infection. Indeed, a defining feature of chorioamnionitis (inflammation of the chorioamnionic fetal membranes) that is associated with more than 40% of preterm births, is neutrophil accumulation. While these cells may play an important role during normal term parturition as well as preterm birth, their functions at the maternal-fetal interface are unclear. This review will provide a broad overview of the relevant studies to enable a better understanding of the roles of neutrophils during normal parturition and preterm birth.
Topics: Female; Humans; Neutrophils; Parturition; Pregnancy; Premature Birth
PubMed: 33218572
DOI: 10.1016/j.placenta.2019.12.010 -
Obstetrics and Gynecology Nov 2021
Topics: Birth Setting; COVID-19; Cesarean Section; Cooperative Behavior; Female; Healthcare Disparities; Home Childbirth; Hospitals; Humans; Infant, Newborn; Maternal Health Services; Parturition; Pregnancy
PubMed: 34619725
DOI: 10.1097/AOG.0000000000004583 -
Health (London, England : 1997) Mar 2022Birth narratives have been found to provide women with the most accessible and often utilised means for giving voice to their exploration of meaning in their births. The...
Birth narratives have been found to provide women with the most accessible and often utilised means for giving voice to their exploration of meaning in their births. The stories women tell of their birth come out of their pre- and post-experience bodies, reproducing society through the sharing of cultural meanings. I recruited a selection of 20 birth stories from a popular 'mums' Internet forum in the United Kingdom. Using structural and thematic analyses, I set out to explore how women tell the story of their body in childbirth. This project has contributed evidence to the discussion of women's experiences of subjectivity in the discursive landscape of birth, while uncovering previously unacknowledged sites of resistance. The linguistic restrictions, sustained by the neoliberal control mechanisms on society and the self, act to shape the reality, feelings, and expressions of birthing women. Naming these silencing strategies, as I have done through the findings of this project, and celebrating women's discourse on birth, as the explosion of birth stories across the Internet are doing, offer bold moves to challenge the muting status quo of women in birth. Reclaiming women's language for birth and working to create a new vocabulary encapsulating the experiences of birthing women will also present opportunities for the issue of birth and women's experiences of it to occupy greater political space with a confident and decisive voice.
Topics: Delivery, Obstetric; Female; Humans; Internet; Narration; Parturition; Pregnancy; United Kingdom
PubMed: 32486867
DOI: 10.1177/1363459320925866