Faith C Diorgu1, Mary P Steen2, June J Keeling3, Elizabeth Mason-Whitehead4. 1. Department of Nursing Science, University of Port Harcourt, Nigeria. Electronic address: faith.diorgu@uniport.edu.ng. 2. School of Nursing & Midwifery, University of South Australia (UniSA), Adelaide, SA 5000, Australia. Electronic address: mary.steen@unisa.edu.au. 3. Faculty of Health and Social Care/Faculty of Medicine, Dentistry and Clinical Sciences, University of Chester, United Kingdom. Electronic address: j.keeling@chester.ac.uk. 4. Dental and Inter-Professional Education, Faculty of Health and Social Care/Faculty of Medicine, Dentistry and Clinical Sciences, University of Chester, United Kingdom. Electronic address: e.whitehead@chester.ac.uk.
Abstract
BACKGROUND: Studies have associated lithotomy position during childbirth with negative consequences and increased risk of perineal injuries. AIMS: To identify prevalence rates of different birthing position and episiotomy and to explore the differences in perspectives of mothers and midwives about birthing positions and perineal trauma. METHODS: A survey involving 110 mothers and 110 midwives at two hospitals. Participants were mothers who had a vaginal birth/perineal injury and midwives who attended births that resulted in perineal injuries. Perceptions of mothers and midwives were analysed. Pearson's chi-square test was used to measure association between birthing positions and perineal trauma. FINDINGS: Mothers, n=94 (85%) and midwives, n=108 (98%) reported high rates of lithotomy position for birth. N=63 (57%) of mothers perceived lithotomy position as not being helpful for birth. In contrast, a similar number of midwives perceived lithotomy position as helpful, n=65 (59%). However, a high majority of mothers, n=106 (96%) and midwives, n=97 (88%) reported they would be willing to use alternative positions. Majority of mothers had an episiotomy, n=80 (73%) and n=76 (69%) reported they did not give their consent. N=59 (53%) reported they were not given local anaesthesia for an episiotomy. n=30 (27%) of midwives confirmed they performed an episiotomy without local anaesthesia. CONCLUSION: Care is not based on current evidence and embedded practices, i.e. birthing in lithotomy position and routine episiotomies are commonly used. However, this survey did find a willingness to change, adapt practice and consider different birthing positions and this may lead to fewer episiotomies being performed.
BACKGROUND: Studies have associated lithotomy position during childbirth with negative consequences and increased risk of perineal injuries. AIMS: To identify prevalence rates of different birthing position and episiotomy and to explore the differences in perspectives of mothers and midwives about birthing positions and perineal trauma. METHODS: A survey involving 110 mothers and 110 midwives at two hospitals. Participants were mothers who had a vaginal birth/perineal injury and midwives who attended births that resulted in perineal injuries. Perceptions of mothers and midwives were analysed. Pearson's chi-square test was used to measure association between birthing positions and perineal trauma. FINDINGS: Mothers, n=94 (85%) and midwives, n=108 (98%) reported high rates of lithotomy position for birth. N=63 (57%) of mothers perceived lithotomy position as not being helpful for birth. In contrast, a similar number of midwives perceived lithotomy position as helpful, n=65 (59%). However, a high majority of mothers, n=106 (96%) and midwives, n=97 (88%) reported they would be willing to use alternative positions. Majority of mothers had an episiotomy, n=80 (73%) and n=76 (69%) reported they did not give their consent. N=59 (53%) reported they were not given local anaesthesia for an episiotomy. n=30 (27%) of midwives confirmed they performed an episiotomy without local anaesthesia. CONCLUSION: Care is not based on current evidence and embedded practices, i.e. birthing in lithotomy position and routine episiotomies are commonly used. However, this survey did find a willingness to change, adapt practice and consider different birthing positions and this may lead to fewer episiotomies being performed.
Authors: Clodoaldo Tentes Côrtes; Sonia Maria Junqueira Vasconcellos de Oliveira; Rafael Cleison Silva Dos Santos; Adriana Amorim Francisco; Maria Luiza Gonzalez Riesco; Gilceria Tochika Shimoda Journal: Rev Lat Am Enfermagem Date: 2018-03-08
Authors: Anna Seijmonsbergen-Schermers; Suzanne Thompson; Esther Feijen-de Jong; Marrit Smit; Marianne Prins; Thomas van den Akker; Ank de Jonge Journal: BMJ Open Date: 2021-01-13 Impact factor: 2.692