The Experience of Land and Water Birth Within the American Association of Birth Centers Perinatal Data Registry, 2012-2017.

Consumer demand for water birth has grown within an environment of professional controversy. Access to nonpharmacologic pain relief through water immersion is limited within hospital settings across the United States due to concerns over safety. The study is a secondary analysis of prospective observational Perinatal Data Registry (PDR) used by American Association of Birth Center members (AABC PDR). All births occurring between 2012 and 2017 in the community setting (home and birth center) were included in the analysis. Descriptive, correlational, and relative risk statistics were used to compare maternal and neonatal outcomes. Of 26 684 women, those giving birth in water had more favorable outcomes including fewer prolonged first- or second-stage labors, fetal heart rate abnormalities, shoulder dystocias, genital lacerations, episiotomies, hemorrhage, or postpartum transfers. Cord avulsion occurred rarely, but it was more common among water births. Newborns born in water were less likely to require transfer to a higher level of care, be admitted to a neonatal intensive care unit, or experience respiratory complication. Among childbearing women of low medical risk, personal preference should drive utilization of nonpharmacologic care practices including water birth. Both land and water births have similar good outcomes within the community setting.

Programa de educación maternal en parto de mínima intervención / Prenatal education program in minimal intervention births

Actualmente, en Atención Primaria, se ofrece un mismo programa de educación maternal para todas las familias, independientemente de la elección del tipo de parto. De esta manera se crean grupos heterogéneos, esto es, familias con distintos objetivos de experiencias de parto y un programa para todos común. Con este artículo, se propone dar un giro a la educación maternal. Se plantea ofrecer una educación maternal basada en la libertad de elección según el tipo de maternidad, parto y crianza que elija la familia. Esto es, diferentes programas de educación maternal para las diferentes opciones de parto. En este artículo se presenta un programa específico de educación maternal dirigido a las familias que desean un parto de mínima intervención

Currently, in Primary Care, the same Maternal Education programme is offered for all families, regardless of their choice of birth plan. This means, heterogeneous groups are formed, ie, families with differing objectives, yet, a common program for all. This article proposes a focus on Maternal Education. This article proposes Maternal Education based on freedom of choice for the family regarding parenthood childbirth and upbringing. So, different programs of Maternal Education for different birth options. This article presents a specific prenatal program designed for families who want a minimum intervention birth

Overcoming fear of facilitating water birth: student and mentor perspectives.

Water immersion for labour and birth is a powerful, low cost intervention that facilitates physiological birth. However, for some midwives - students or qualified - a lack of exposure to water births can create fearful perceptions and reduce their willingness to support women in water. This article explores the nature of this fear, and how it was overcome from the perspectives of both the mentor and student, perhaps offering useful insights for others.

Web-based education and attitude to delivery by caesarean section in nulliparous women.

OBJECTIVE: To measure the effect of a web-based educational tool on baseline knowledge of the risks and benefits of delivery by Caesarean section in healthy nulliparous women. METHODS: We constructed a web-based educational tool to provide evidence-based information on the potential benefits and risks of CS for healthy nulliparous women in the second trimester. We included women with an uncomplicated singleton pregnancy who were receiving antenatal care at Mount Sinai Hospital. Eligible women logged into the website to undertake a pre-test survey. After completing this survey, they received access to the educational tool, followed by a link to a second survey. The surveys collected baseline demographics and assessed participants' knowledge of the perceived safety and risks of vaginal delivery and CS, their sources of information, and the influence of these sources on their views. RESULTS: Seventy-three participants completed both surveys. Participants had a high baseline preference (84%) for vaginal delivery. The mean score for knowledge about vaginal delivery and CS increased significantly between the surveys, from 47% to 76% (P < 0. 001). There was no significant change in preference for mode of delivery between the two surveys. In both surveys, more participants responded that they were a "little fearful" or "not fearful at all" of vaginal deliveries. In the second survey, significantly more responded that they were "very fearful" or "fearful" of CS (P < 0.05). Increased knowledge about specific risks of vaginal delivery did not deter participants from preferring a vaginal delivery. However, knowledge of risks associated with CS made them more likely to have "very favourable" or "somewhat favourable" views of vaginal delivery. Ethnicity and country of birth were not found to have a significant effect on preferred mode of delivery. CONCLUSIONS: We demonstrated that a web-based educational tool significantly increased knowledge of the risks and benefits of vaginal delivery and CS. However, the educational intervention did not significantly change preferences.

Objectif : Mesurer l'effet d'un outil pédagogique Web traitant des connaissances de base sur les risques et les avantages de la césarienne chez les nullipares en santé. Méthodes : Nous avons créé un outil pédagogique Web visant à fournir des renseignements factuels sur les risques et les avantages possibles de la césarienne chez les nullipares en santé pendant le deuxième trimestre. Nous avons inclus des femmes présentant une grossesse monofœtale sans complications qui recevaient des soins prénatals au Mount Sinai Hospital. Les femmes admissibles ont ouvert une session sur le site Web afin de remplir un sondage prétest. Une fois le sondage rempli, elles ont obtenu accès à l'outil pédagogique et ont reçu un lien menant à un deuxième sondage. Ces sondages ont permis de recueillir des données démographiques de référence et d'évaluer les connaissances des participantes quant à l'innocuité et aux risques perçus de l'accouchement vaginal et de la césarienne, leurs sources d'information et l'influence qu'avaient ces sources sur leurs opinions. Résultats : Soixante-treize participantes ont rempli les deux sondages. Elles présentaient, au départ, une préférence élevée (84 %) pour l'accouchement vaginal. Le score moyen quant aux connaissances sur l'accouchement vaginal et la césarienne a augmenté considérablement entre les sondages, passant de 47 % à 76 % (P < 0,001). Aucun changement appréciable n'a été constaté entre les sondages en ce qui concerne la préférence en matière de mode d'accouchement. Dans les deux sondages, plus de participantes ont dit ne ressentir « aucune crainte ¼ ou ressentir « une légère crainte ¼ relativement à l'accouchement vaginal. Dans le deuxième sondage, par contre, un nombre considérablement plus élevé de participantes ont dit ressentir « de la crainte ¼ ou « beaucoup de crainte ¼ en ce qui concerne la césarienne (P < 0,05). L'amélioration des connaissances à propos des risques propres à l'accouchement vaginal n'a pas empêché les participantes de continuer de privilégier l'accouchement vaginal. Toutefois, le fait d'en connaître plus au sujet des risques associés à la césarienne les rendait plus susceptibles d'avoir une opinion « relativement favorable ¼ ou « très favorable ¼ à l'égard de l'accouchement vaginal. L'ethnicité et le pays d'origine n'ont eu aucun effet appréciable sur la préférence en matière de méthode d'accouchement. Conclusions : Nous avons démontré que l'utilisation d'un outil pédagogique Web améliorait considérablement les connaissances sur les risques et les avantages de l'accouchement vaginal et de la césarienne. Toutefois, l'intervention pédagogique n'a pas modifié les préférences de façon marquée.

Childbirth in aristocratic households of Heian Japan

This paper focuses on childbirth in Japan's aristocratic households during the Heian period (794-1185). Drawing on various sources, including court diaries, visual sources, literary records, and Japan's first medical collection, with its assortment of gynaecological and obstetric prescriptions, as well as Buddhist and other ritual texts, this short excursion into the cultural history of childbirth offers an insight into how childbirth was experienced and managed in Heian Japan. In particular, it addresses the variety of ideas, knowledge systems and professionals involved in framing and supporting the process of childbirth in elite households. In so doing, it casts light on the complex background of early Japanese medicine and healthcare for women (AU)

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A birth education program for expectant fathers in Taiwan: effects on their anxiety.

BACKGROUND: A father who does not know how to assist the mother in relieving labor pains may experience a sense of powerlessness and anxiety. The objective of this study was to evaluate how an education program for expectant fathers who attended their partners' labor and birth affected their anxiety. METHODS: In a randomized controlled trial, 87 expectant fathers who attended their pregnant partners through labor and birth at a hospital in central Taiwan were allocated by block randomization to an experimental (n = 45) and a control (n = 42) group. The men completed their basic personal information, a childbirth expectations questionnaire, and a Trait Anxiety Inventory when they were recruited. Two hours after birth of their child, all the expectant fathers completed a State of Anxiety Inventory. RESULTS: Our results showed no statistically significant differences between the experimental and control groups of fathers in trait anxiety and their prenatal childbirth expectations. After analysis of covariance (ANCOVA) was applied to correct for education level, sources of childbirth information, attendance at Lamaze childbirth classes, and childbirth expectations at baseline, the effect of the childbirth program was significant for the postnatal level of anxiety (F = 3.38, p = 0.001). CONCLUSIONS: The study findings justify the clinical implementation of a birth education program based on the self-efficacy theory as an effective means of reducing anxiety among expectant fathers.

Prevalencia de la lactancia materna en el Área Básica de Salud Sant Feliu-2 (Barcelona) / No disponible

Objetivo: estudiar la prevalencia del tipo de lactancia y de sus factores condicionantes en nuestra Área Básica de Salud (ABS). Material y métodos: estudio descriptivo transversal, mediante encuesta telefónica, en 200 niños nacidos en el año 2003. Variables estudiadas: tipo y duración de la lactancia materna (LM), uso de pezonera, suplementos de biberón, edad materna, nivel de estudios, procedencia, situación laboral, número de hijos, tipo de parto, hábito tabáquico, fuente de información y motivo de abandono de la LM. Análisis de los datos: estadísticos descriptivos, prueba de chi al cuadrado y análisis multivariante. Resultados: el 74% de mujeres inicia LM, el 25,5% sigue LM a los 6 meses, y el 3,5% a los 12 meses. La duración media de la LM exclusiva (LME) fue de 3,21 meses (desviación estándar [DE]: 3,32 meses). Se ha encontrado una asociación significativa entre ser inmigrante y la LM al mes de vida (p = 0,0022) y LM a los 6 meses [p < 0,0005, odds ratio (OR) de 6,9 (intervalo de confianza [IC] 95%: 2,23-23,05]. También entre un mayor nivel de estudios y LM al mes de vida (p = 0,007). OR = 1,7 (IC 95%: 1,05-2,75). El resto de variables estudiadas no tiene significación estadística. Conclusiones: el porcentaje de inicio de LM es ligeramente inferior al de otros estudios de nuestro entorno; las mujeres que inician LM la mantienen durante más tiempo. Factores favorecedores son un mayor nivel de estudios y ser inmigrante. Debemos potenciar la LM antes y en los primeros días después del parto (AU)

Objective: to study the prevalence of maternal lactation of our health area, and its conditioning factors. Methodology: cross-sectional descriptive study, by means of telephone survey, of 200 children born in 2003. Studied variables: type of lactation and duration of the breastfeeding, use of nipple protector, supplements of baby’s bottle, maternal age, level of studies, origin, work situation, number of children, type of childbirth, smoking habit, information on breastfeeding and reason for abandonment. Analysis of data: statistical descriptive, chi square test, and multivariate analysis. Results: 74% of women initiate breastfeeding, 25.5% follow breastfeeding at 6 months, and 3.5% maintain it until 12 months. The average duration of exclusive breastfeeding was of 3.21 months (standard deviation [SD]: 3.32). A significant association has been found between being immigrant and breastfeeding at one month of life (p = 0, 0022) and breastfeeding at 6 months (p < 0, 0005). Odds Ratio (OR) of 6.9 (confidence interval [CI] 95%: 2, 23-23, 05). Also between mothers with higher level of studies and breastfeeding at one month of life (p = 0,007). OR = 1.7 (CI 95%: 1, 05-2,75). The rest of the studied variables do not have statistical meaning. Conclusions: the percentage of mothers who initiate breastfeeding is slightly inferior to other studies of our surroundings; women who initiate breastfeeding, maintain it for longer. A higher level of studies and being an immigrant are helping factors for breastfeeding. We must promote maternal education before and during the first days after hospital discharge (AU)