Healing Architecture in Birthing Rooms: A Scoping Review.

AIM: The purpose of this scoping review is to map the knowledge about the multisensory birthing room regarding the birth experience and birth outcomes. BACKGROUND: The concept of multisensory birthing rooms is relatively novel, making it relevant to explore its impact. METHODS: Five databases were searched. The search was limited to articles in English, Danish, Norwegian, and Swedish. There were no time limitations. Fourteen relevant articles were identified providing knowledge about multisensory birthing rooms. RESULTS: Eight articles focused on birth experience, six articles focused on birth outcome, and one on the organization of the maternity care. Seven of the studies identified that sensory birthing rooms have a positive impact on the birth experience and one qualitative study could not demonstrate a better overall birth experience. Five articles described an improvement for selected birth outcomes. On the other hand, a randomized controlled trial study could not demonstrate an effect on either the use of oxytocin or birth outcomes such as pain and cesarean section. The definition and description of the concept weaken the existing studies scientifically. CONCLUSIONS: This scoping review revealed that multisensory birthing rooms have many definitions and variations in the content of the sensory exposure; therefore, it is difficult to standardize and evaluate the effect of its use. There is limited knowledge concerning the multisensory birthing room and its impact on the birth experience and the birth outcome. Multisensory birthing rooms may have a positive impact on the birth experience. Whereas there are conflicting results regarding birth outcomes.

Discharge time after birth is associated with parity - A retrospective cohort study.

Background: All healthy mothers with uncomplicated births are recommended to be discharged directly from the labour ward a few hours after birth as a change in practice in three hospitals in Denmark. However, despite this practice, there is limited knowledge about when mothers leave the hospital after birth in clinical practice. Objective: The aim of this study is to examine 1) when mothers are discharged from hospital after birth, 2) if discharge time from the hospital after birth is associated with parity, and 3) which factors are associated with discharge time. Methods: This retrospective study is based on data from the North Denmark Regional Hospital and included mothers giving vaginal birth from March 25, 2019 to April 10, 2021. Results: A total of 1990 mothers were included. Nearly 50% of the new mothers stayed at the hospital less than 6 h after birth (26% of primiparous women vs 64% of multiparous women). Primiparous women had an adjusted RR 0.44 (95% CI 0.39-0.49) for discharge ≤6 h, RR 1.71 (95% CI 1.15-2.54) for discharge >6-12 h, and RR 3.76 (95% CI 3.03-4.67) for discharge >48 h after birth compared to multiparous women. Multiparous women's adjusted RR for discharge >6-12 h was 0.15 (95% CI 0.12-0.20) and for discharge >48 h 0.16 (95% CI 0.14-0.20) compared to discharge less than 6 h after birth. Furthermore, smoking, low education level, and younger age were associated with early discharge. Conclusion: There is a significant association with parity and discharge time after birth and factors related to discharge time which healthcare professionals should be aware of when planning inpatient and outpatient care. In addition, healthcare professionals should be aware of mothers discharged early who are smoking, of younger age, lower education level or multiparity.

Do women's perceptions of their childbirth experiences change over time? A six-week follow-up study in a Danish population.

OBJECTIVE: To evaluate how women's perception of the childbirth experience developed during the postpartum period. The secondary aim was to explore how selected birth interventions were subjectively perceived as part of the birth experience. DESIGN: A prospective cohort study comparing childbirth experience, assessed at one and six weeks postpartum, using the Childbirth Experience Questionnaire (CEQ). SETTING: A regional hospital in the northern part of Denmark, with 1,400 childbirths annually. PARTICIPANTS: A total of 201 women with low-risk births who gave birth at North Denmark Regional Hospital were included in this study. We included both nulliparous and multiparous women. MEASUREMENTS AND FINDINGS: More than 50% of the women changed their perceptions about their childbirth experience after six weeks. After six weeks the overall CEQ score and the domains 'Participation' and 'Professional support' had a lower CEQ score compared to scores obtained one week postpartum, although differences were small. Induction of labor, augmentation of labor, emergency caesarean section, epidural analgesia, and use of nitrous oxide were associated with a lower CEQ score. KEY CONCLUSIONS: Women assessed their overall birth experience more negatively at six weeks postpartum compared to one week postpartum. Some interventions in the labor process influenced the women's assessment of their experiences negatively. IMPLICATIONS FOR PRACTICE: Paying attention to preventive initiatives to ensure the women a spontaneous birth, if possible, may be essential to create positive perceptions of the childbirth experience.

Primiparous women differ from multiparous women after early discharge regarding breastfeeding, anxiety, and insecurity: A prospective cohort study.

INTRODUCTION: Breastfeeding and factors influencing breastfeeding are essential when considering the association between parity and neonatal and maternal morbidity risks when mothers are discharged within 24 hours after birth. However, there is a lack of studies examining the effect of parity and breastfeeding in a setting where all healthy mothers are recommended discharge four hours after birth. Therefore, this study examined the association between parity and the time for discharge, breastfeeding, and factors influencing breastfeeding. METHODS: The study was designed as a prospective cohort study. Data were obtained from questionnaires at one and at six weeks after birth, and combined with registered data. All 147 included mothers were healthy, with an uncomplicated birth and a healthy newborn, discharged within 24 hours after birth. RESULTS: This study documented that primiparous women had a higher relative risk (RR=2.62; 95% CI: 1.35-5.10) of having doubts about infant feeding after discharge than multiparous women. Furthermore, 54% of primiparous women contacted the maternity ward after discharge compared to 27% of multiparous women. Twice as many primiparous than multiparous women felt anxious or depressed at one and at six weeks after birth. Finally, the study documented that 13% of primiparous women and 5% of multiparous women discharged within six hours after birth perceived the time before discharge to be too short. CONCLUSIONS: Primiparous women differ from multiparous women regarding breastfeeding, insecurity, and anxiety. Special attention towards primiparous women and a follow-up strategy that allows the mothers to contact the maternity ward after early discharge is recommended.

[Acute caesarian section due to renal tumour with spontaneously emerged perirenal haematoma].

A primipara at term was admitted to the labour ward with spontaneously emerged severe abdominal pain in the right flank and kidney. The patient was not known with any obstetric or urologic conditions. An acute caesarian section was performed due to the pain and pathological results of the cardiotocography, and a healthy child was delivered. During surgery, a haematoma was detected in the retroperitoneal space. A computed tomography (CT) of abdomen showed a Bosniak type IV tumour with surrounding haematoma in the kidney. Due to persistent tumour on control CT after six weeks, a laparoscopic nephrectomy was performed, and a renal cell carcinoma could be seen.

[Rupture of the spleen following Caesarean section]. / Miltruptur efter sectio.

A case of rupture of the spleen after Caesarean section is presented. Rupture of the spleen is a rare complication of pregnancy. The aetiology of splenic rupture is discussed. It is important to keep this rare condition in mind. Fast intervention limits the effects of this potentially lethal condition.