Pushing methods used by UK midwives during the second stage of labour: current practice and rationale. Research proposal Name: Course: Professor: Institution: City and State: Date: Contents Pushing methods used by UK midwives during the second stage of labour: current practice and rationale…
12 Midwifery Care Measures in the Second Stage of Labour and Reduction of Genital Tract Trauma at Birth: A Randomized Trial 13 Abstract 13 Effects of pushing techniques in birth on mother and fetus: a randomized study. 14 Abstract 14 Active pushing versus passive fetal descent in the second stage of labour: a randomized controlled trial. 15 Source 15 Abstract 15 A randomized trial of coached versus uncoached maternal pushing during the second stage of labour. 17 Abstract 17 Source 17 Abstract 17 Pushing methods used by UK midwives during the second stage of labour: current practice and rationale. 1.0 Background The second stage of labour is the period between the moment when the cervix attains complete dilatation and when the baby is born (Caldeyro-Barcia et al. 1981). This stage is portrayed by frequent and regular contractions and it is the period when the mother experiences rectal pressure, vaginal pressure, and an irresistible need to push down. For a long time in the history, the management of the second stage of labour has consisted of a set of behaviors that start when the midwives become aware that the woman has attained full dilatation and hence prepared to push. The midwives proceed by instructing the mother to continue pushing while holding their breath, with successful contractions (Hanson 2006; Hansen, Clark and Foster, 2002). This kind of practice has been done by many midwives for the purpose of shortening the occurrence of the second stage of labour and speeding up fetal descent, though the rationale and safety of the practice has not been substantiated (Yildirim, Beji, 2008). Nevertheless, there is mounting evidence showing that unplanned pushing is a better way of managing the second stage of labour than directed planning, which is typically done by Valsalva maneuver. When all is said and done, many midwives in the United Kingdom (U.K.) and other parts of the world have continuously adopted the directed mode of attending to mothers when giving birth, during the second period of labour. A recent study by Osborne (2010) found that midwives felt the need of supporting women without epidural anesthesia to start the efforts of bearing-down on when the women felt the need to do so. The majority of the participants, however, revealed that they did not provide direction when helping the mothers, which means many of them often, supported spontaneous bearing-down. Their study further revealed that most of the midwives started providing directive support when the fetal head appeared and when the final drawing out of the perineum was occurring. The other factor that influenced directive support was the tendency by the mothers to ask for more direction or when they appeared to be exhausted (Osborne 2010) An unplanned push is accompanied by a release of numerous breaths and air within the intervals of bearing-down attempts (Roberts et al. 1987; Bloom 2006). Albers et al. (2005) scrutinised pushing techniques used by Certified Nurse-Midwives (CNMs) and found that the largest proportion of midwives preferred non-Valsalva methods. For quite a long time, the practice of subjecting women to long pushes in the course of the second-stage of labour has been disapproved by critics. 2.0 Introduction The practice of midwifery is premised on the view that labour and birth are ordinary physiological phenomenon that takes place in the life of a woman. The practice of m ...
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