Childbirth Outcomes and Perineal Damage in Women with Natural Childbirth : A Review of Medical Records in a Natural Birth Center in Korea

Background and objective: In obstetrics training, there are gaps in the scientific evidence on how to teach safe practices with respect. The objective of this study was to explore from the point of view of the preceptors how the process of training obstetricians (physicians and nurses) in residency leads to the development and inculcation of the practices recommended by the national and international guidelines for assistance with natural childbirth.Methods: Qualitative, exploratory-descriptive study. Thirty-five professionals, including 21 physicians and 14 nurses, from a public institution in the Midwest of Brazil participated in the study. Data were collected through face-to-face interviews conducted from March to June 2018. They were categorized into emerging themes, supported by NVivo to natural birth ® software. Two researchers reviewed the data, and by consensus, the identified issues were confirmed.Results: Of the participants’ comments, 4 themes were codified: approach of the good practices in natural childbirth care; unnecessary practices that remain in use; norms and routines in natural childbirth care; and work processes in the obstetric residency program.Conclusions: The results highlight the necessity of reorganization of the work processes in the residency program, with continuous action directed toward the strengthening of pedagogical processes and the qualification of the actors involved in the formation and organization of childbirth care services to expand the disruptive potential of new health professionals.

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Obstetric practices performed by nurse-midwives of a hospital natural birth center

Escola Anna Nery ◽

10.1590/2177-9465-2019-0112 ◽

2019 ◽

Vol 23 (4) ◽

Author(s):

Juliana Manoela dos Santos Freitas ◽

Nádia Zanon Narchi ◽

Rosa Aurea Quintella Fernandes

Keyword(s):

Neonatal Outcomes ◽

World Health ◽

Cross Sectional ◽

Exact Test ◽

Neonatal Complications ◽

Birth Center ◽

Natural Birth ◽

Maternal And Neonatal Outcomes ◽

Nurse Midwives ◽

Health Organization

Abstract Objectives: To characterize the practices used by nurse-midwives in a Natural Birth Center (NBC) and to verify the maternal and neonatal outcomes. Method: This was a cross-sectional, documentary, retrospective study with a quantitative approach in which the medical records of 300 parturients who gave birth in a state hospital in the city of São Paulo were analyzed. The categories of the World Health Organization (WHO) composed the criteria adopted for the analysis of the obstetric practices. Fisher's exact test or the likelihood ratio and Student t-test were used. Results: The nurse-midwives mostly used category A practices of the WHO. There were no statistically significant associations between practices and perineal outcomes. There was a statistically significant association between the weight of the newborn and the number of neonatal complications, as well as between the delivery position of the primiparous women and clavicle fractures of the newborns. Conclusion and Implications for the practice: Evidence-based practices were followed by the nurse-midwives in the NBC analyzed. The maternal and neonatal outcomes were adequate. There is a need to improve care in the second stage of the delivery in order to avoid behaviors that reflect in neonatal complications. The study makes it possible to reflect on the importance of the continuous evaluation of the care provided.

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The “good” epidural: Women’s use of epidurals in relation to dominant discourses on “natural” birth

Feminism & Psychology ◽

10.1177/0959353520944808 ◽

2020 ◽

pp. 095935352094480 ◽

Cited By ~ 1

Author(s):

Sunna Símonardóttir ◽

Annadís Greta Rúdólfsdóttir

Keyword(s):

Pain Relief ◽

Epidural Analgesia ◽

Model Of Care ◽

Natural Childbirth ◽

Natural Birth ◽

First Time Mothers ◽

Research Gap ◽

Dominant Discourses ◽

Effective Pain Relief ◽

First Time

Childbirth is widely recognized to be among the most painful of experiences, and the most common and effective pain relief for birthing women is known to be the use of epidural analgesia. The increase in the use of epidural analgesia for birthing women has been described by some critics as a by-product of the medicalized model of birth, although there remains a notable dearth of research regarding women’s experiences of epidurals. The present paper seeks to address this research gap by examining how first-time mothers in Iceland discuss their intentions concerning pain relief during birth, along with how they construct childbirth-related pain and the use of epidural analgesia in the context of a midwife-led model of care and an institutionalized preference for “natural” birth. The findings demonstrate that, despite initial intentions, most of the women end up having an epidural, and most describe their epidurals as both wonderful and immensely helpful. The dominant narrative about “natural” childbirth being preferable is not fully refuted by this. Instead, the women either align themselves with the ideology of the capable and knowing body or resist and contest this narrative by constructing their birthing bodies as open to, and in need of, assistance.

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RESULTADOS MATERNOS E NEONATAIS EM CENTRO DE PARTO NORMAL INTRA-HOSPITALAR

Enfermagem em Foco ◽

10.21675/2357-707x.2018.v9.n1.1101 ◽

2018 ◽

Vol 9 (1) ◽

Author(s):

Camila Soares Teixeira ◽

Valdelize Elvas Pinheiro ◽

Iracema Da Silva Nogueira

Keyword(s):

Public Health ◽

Medical Records ◽

Descriptive Study ◽

Neonatal Outcomes ◽

World Health ◽

Perineal Laceration ◽

Birth Center ◽

Hospital Birth ◽

The World ◽

Maternal And Neonatal Outcomes

Objetivo: descrever os resultados maternos e neonatais da assistência no Centro de Parto Normal Intra-hospitalar da Maternidade Balbina Mestrinho em Manaus. Método: pesquisa exploratório-descritiva, com abordagem quantitativa, onde realizou-se a análise de 378 (74,85%) prontuários de partos assistidos entre setembro de 2014 a 2016. Resultados: A maioria das parturientes (50,79%) era jovem, entre 18 e 25 anos e multíparas (74,86%), permaneceram em média 03 horas e 14 minutos em trabalho de parto e acompanhadas (97,35%). Obteve-se uma taxa de episiotomia de 8,46% e laceração perineal de 52,37% predominando as de primeiro grau (38,62%). A maioria dos recém-nascidos permaneceu em contato pele a pele (86,60%) e foi realizado o clampeamento tardio do cordão umbilical (77,78%). A média do Apgar no primeiro minuto fora de 8,72 e no quinto minuto 9,76. Conclusões: Os resultados condizem com o que preconiza o Ministério da Saúde e a Organização Mundial de Saúde.Descritores: enfermagem obstétrica; parto humanizado; políticas públicas de saúdeMATERNAL AND NEONATAL OUTCOMES AT THE IN-HOSPITAL BIRTH CENTERObjective: to describe the maternal and neonatal outcomes of the care provided at the In-hospital birth center. Method: an exploratory, descriptive study with quantitative approach where the analysis of 378 (74,85%) birth assisted medical records was performed from September 2014 to September 2016. Results: the majority of parturients (50,79%) was young, between 18 and 25 years old and multiparas (74,86%). The result obtained was an episiotomy rate of 8,46% and 52,37% of perineal laceration, predominating the first degree lacerations. The majority of newborns remains in skin-to-kin (86,60%) and was made the late clamping umbilical cord (77,78%). The average of Apgar’s rate was 8,72 in the first minute and 9,76 in the fifth. Conclusion: The results meet the guidelines adopted by the Ministry of Health and the World Health Organization.Descriptors: obstetric nursing; humanizing delivery; public health policiesRESULTADOS MATERNOS Y NEONATALES EN CENTRO DE PARTO NORMAL INTRAHOSPITALARIOObjetivo: describir los resultados maternos y neonatales de cuidados en el Centro de Parto Normal Intrahospitalario de la Maternidad Balbina Mestrinho en Manaus. Método: estudio exploratorio descriptivo con un enfoque cuantitativo, que llevó a cabo el análisis de 378 (74.85%) de los nacimientos asistidos, registros a partir de septiembre de 2014 y 2016. Resultados: La mayoría de las madres (50,79%) eran joven entre 18 y 25 años de edad y multíparas (74,86%) eran, en promedio, 03 horas y 14 minutos y seguido de trabajo de parto acompañadas (97,35%). Obtenido como una tasa de episiotomías de 8,46% y 52,37% laceración perineal el predominio de primer grado (38,62%). La mayoría de los recién nacidos se mantuvieron en contacto con la piel (86,60%) y se llevó a cabo a finales de sujeción del cordón umbilical (77,78%). El promedio de Apgar en el primer minuto fuera de 8,72 y 9,76 en el quinto minuto. Conclusiones: Los resultados son consistentes con la recomendada por el Ministerio de Salud y la Organización Mundial de la Salud.Descriptores: enfermeria obstetricia; parto humanizado; las políticas de salud pública

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Humanização do parto na perspectiva da equipe de enfermagem de um Centro de Parto Normal

Enfermagem em Foco ◽

10.21675/2357-707x.2020.v11.n3.3256 ◽

2020 ◽

Vol 11 (3) ◽

Author(s):

José Wellington Silva De Moura ◽

John Carlos De Souza Leite ◽

Vinícius Rodrigues De Oliveira ◽

João Paulo Xavier Silva

Keyword(s):

Qualitative Research ◽

Nursing Care ◽

Nurse Practitioners ◽

Care Nurse ◽

Categorical Analysis ◽

Birth Center ◽

Natural Birth ◽

Nursing Team ◽

Study Participants ◽

Nursing Professionals

Objetivo: Compreender a percepção de uma equipe de enfermagem de um Centro de Parto Normal acerca da assistência ao parto humanizado. Método: Trata-se de uma pesquisa descritiva, qualitativa, realizada com profissionais de enfermagem de um Centro de Parto Normal, em um município do interior do Ceará. Os dados foram analisados segundo a análise categorial temática, utilizando-se o software IRAMUTEQ para processamento dos dados. Resultados: Os participantes do estudo reconhecem a relevância de seu trabalho e identificam a classe da enfermagem como protagonista na assistência humanizada. Esses apresentam a percepção de parto humanizado relacionado à autonomia da mulher, além disso, entendem que o processo de humanização se inicia desde a entrada da mulher no centro de parto. Conclusão: Os profissionais de enfermagem demonstraram conhecimento científico sobre a assistência ao parto humanizado e sobre as práticas de humanização para a parturiente.Descritores: Parto humanizado; Cuidados de enfermagem; Profissionais de enfermagem; Enfermagem obstétrica. BIRTH HUMANIZATION IN THE PERSPECTIVE OF THE NURSING TEAM OF A NATURAL BIRTH CENTERObjective: Comprehend the perspective of a nursing team in a natural birth center about the assistance on humanized childbirth. Methodo: this is a descriptive, qualitative research carried out with nursing professionals of a natural birth center, in a municipality in the interior of Ceará. The data were analyzed according to the thematic categorical analysis, using IRAMUTEQ software in data processing. Results: The study participants recognize the relevance of their work and identify the nursing class as the protagonist in humanized care. This present the perception of humanized birth related to women's autonomy, also, they understand that the humanization process begins when the woman enters the birth center. Conclusion: Nursing professionals demonstrated scientific knowledge about humanized childbirth assistence, and about humanization practices for parturient women.Descriptors: Humanizing Delivery; Nursing Care; Nurse Practitioners; Obstetric Nursing.HUMANIZACIÓN DEL PARTO NA PERSPECTIVA DEL EQUIPO DE ENFERMERÍA DE UN CENTRO DE PARTO NORMALObjetivo: Comprender la percepción de un equipo de enfermería en un Centro de Parto Normal acerca de la asistencia humanizada para el parto. Metodo: Esta es una investigación descriptiva y cualitativa, realizada con profesionales de enfermería de un Centro de Parto Normal, en una ciudad del interior de Ceará. Los datos se analizaron de acuerdo con el análisis categórico temático, utilizando un software IRAMUTEQ en el procesamiento de datos. Resultados: Los participantes del estudio reconocen la relevancia de su trabajo e identifican a la clase de enfermería como protagonista en la atención humanizada. Estos presentan la percepción del parto humanizado en relación con la autonomía de la mujer, además, entienden que el proceso de humanización comienza desde el ingreso de la mujer al centro de parto. Conclusión: Los profesionales de enfermería demostraron conocimiento científico sobre el cuidado del parto humanizado y sobre las prácticas de humanización para mujeres parturientas.Descriptores: Parto Humanizado; Atención de Enfermería; Enfermeras Practicantes; Enfermería Obstétrica.

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Natural Childbirth Movement in Hungary

Медицинская антропология и биоэтика ◽

10.33876/2224-9680/2020-2-20/02en ◽

2020 ◽

Author(s):

Barbara Kisdi

Keyword(s):

Natural Process ◽

Natural Childbirth ◽

Generic Term ◽

Natural Birth ◽

Behavior Science ◽

Health And Disease ◽

The Relationship ◽

Critical Movement

As the behavior science, preventive approach and health-oriented worldview gradually permeate the whole of medicine, transformations in obstetrics are occurring slowly all around the world. The technocratic character of the medical approach to obstetrics strives to keep the intrinsically natural process under total control of medicine, which has provoked the emergence of the critical movement known as the natural birth movement. However, this generic term is only used theoretically in Hungary because the movement is yet to develop a single base that would bring together its separate units. One of the most important units of the natural birth movement is the doulas community which, after twenty years of differentiation, is seeking possibilities for cooperation, joint action and representation of natural childbirth. In this article, I would like to discuss this process, which reachesbeyond its own frameworks – since it affects not merely the quality of obstetrics but also modern and post-modern definitions of health and disease, the system of power, gender roles, distribution of knowledge, the relationship between nature and technology, as well as the long-term problem of the quality of life within the society – significant questions not only for Hungary.

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Impairment Tutorial: Spinal Cord Stimulation and Intraspinal Opioids:Impairment Rating Issues

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2000.sepoct04 ◽

2000 ◽

Vol 5 (5) ◽

pp. 4-5

Author(s):

James B. Talmage ◽

Leon H. Ensalada

Keyword(s):

Medical Records ◽

Evaluation Process ◽

Current Approach ◽

Satisfaction Survey ◽

Start Time ◽

Medical Evaluation ◽

Independent Medical Evaluation ◽

Other Information ◽

Physician Reviews ◽

Written Informed Consent

Abstract Evaluators must understand the complex overall process that makes up an independent medical evaluation (IME), whether the purpose of the evaluation is to assess impairment or other care issues. Part 1 of this article provides an overview of the process, and Part 2 [in this issue] reviews the pre-evaluation process in detail. The IME process comprises three phases: pre-evaluation, evaluation, and postevaluation. Pre-evaluation begins when a client requests an IME and provides the physician with medical records and other information. The following steps occur at the time of an evaluation: 1) patient is greeted; arrival time is noted; 2) identity of the examinee is verified; 3) the evaluation process is explained and written informed consent is obtained; 4) questions or inventories are completed; 5) physician reviews radiographs or diagnostic studies; 6) physician records start time and interviews examinee; 7) physician may dictate the history in the presence of the examinee; 8) physician examines examinee with staff member in attendance, documenting negative, physical, and nonphysiologic findings; 9) physician concludes evaluation, records end time, and provides a satisfaction survey to examinee; 10) examinee returns satisfaction survey before departure. Postevaluation work includes preparing the IME report, which is best done immediately after the evaluation. To perfect the IME process, examiners can assess their current approach to IMEs, identify strengths and weaknesses, and consider what can be done to improve efficiency and quality.

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Abstract # P-1: Use of Type 2 Diabetes Screening Guidelines in Primary Care: Concordance Between Physician Survey and Medical Records

Endocrine Practice ◽

10.1016/s1530-891x(20)43814-5 ◽

2016 ◽

Vol 22 ◽

pp. 14

Author(s):

Michelle Mocarski ◽

Sandhya Mehta ◽

Karin Gillespie ◽

Tami Wisniewski ◽

K.M. Venkat Narayan ◽

...

Keyword(s):

Type 2 Diabetes ◽

Primary Care ◽

Medical Records ◽

Physician Survey ◽

Diabetes Screening ◽

Screening Guidelines

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Percutaneous sclerotherapy for spongiform venous malformations – analysis of patient-evaluated outcome and satisfaction

VASA ◽

10.1024/0301-1526/a000650 ◽

2017 ◽

Vol 46 (6) ◽

pp. 477-483

Author(s):

Robert Karl Clemens ◽

Frederic Baumann ◽

Marc Husmann ◽

Thomas Oleg Meier ◽

Christoph Thalhammer ◽

...

Keyword(s):

Retrospective Study ◽

Medical Records ◽

Venous Malformation ◽

Primary Treatment ◽

Venous Malformations ◽

Treated Area ◽

Item Questionnaire ◽

Percutaneous Sclerotherapy ◽

Multiple Treatments ◽

Pain Improvement

Abstract. Background: Congenital venous malformations are frequently treated with sclerotherapy. Primary treatment goal is to control the often size-related symptoms. Functional impairment and aesthetical aspects as well as satisfaction have rarely been evaluated. Patients and methods: Medical records of patients who underwent sclerotherapy of spongiform venous malformations were reviewed and included in this retrospective study. The outcome of sclerotherapy as self-reported by patients was assessed in a 21 item questionnaire. Results: Questionnaires were sent to 166 patients with a total of 327 procedures. Seventy-seven patients (48 %) with a total of 159 procedures (50 %) responded to the survey. Fifty-seven percent of patients were male. The age ranged from 1 to 38.1 years with a median age of 16.4 years. The lower extremities were the most common treated area. Limitations caused by the venous malformation improved in the majority of patients (e.g. pain improvement 87 %, improvement of swelling 83 %) but also worsening of symptoms occurred in a minority of cases. Seventy-seven per cent would undergo sclerotherapy again. Conclusions: Sclerotherapy for treatment of venous malformations results in significant reduction of symptoms. Multiple treatments are often needed, but patients are willing to undergo them.

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