Assessing feasibility and maternal acceptability of a biomechanically-optimized supine birth position: A pilot study

Background In order to manage a protracted second stage of labor, “eminence-based” birth positions have been suggested by some healthcare professionals. Recent biomechanical studies have promoted the use of an optimized supine birthing position in this setting. However, uncertainty exists regarding the feasibility of this posture, and its acceptability by women. This pilot study primarily aimed to assess these characteristics. Objective and methods In this monocentric prospective study, 20 women with a protracted second stage of labor were asked to maintain a biomechanically-optimized position for at least 20 minutes at full dilatation. This posture is similar to the McRoberts’ maneuver. Maintaining the position for 20 minutes or more was considered clinically relevant and indicative of feasibility and acceptability. Satisfaction with the position was assessed using a Visual Analogue Scale (VAS). A sub-group analysis was performed to assess eventual differences between more and less satisfied patients, according to the median of patients’ satisfaction scores. Results Seventeen patients (85%) maintained the optimized position for at least 20 minutes. The median satisfaction score of these participants was 8 (interquartile range: 1) out of 10. No significant differences were found between the two sub-groups (satisfaction score <8 vs satisfaction score ≥8) regarding general and obstetric characteristics, as well as obstetrical and fetal outcomes. Conclusion The optimized position is acceptable and feasible for women experiencing a protracted second stage of labor. Further clinical studies are needed to assess the efficiency of such positions when women undergo an obstructed labor.

Effect of maternal birth positions on duration of second stage of labor: systematic review and meta-analysis

Background It is believed that giving birth in an upright position is beneficial for both mother and the infant for several physiologic reasons. An upright positioning helps the uterus to contract more strongly and efficiently, the baby gets in a better position and thus can pass through the pelvis faster. Upright and lateral positions enables flexibility in the pelvis and facilitates the extension of the outlet. Before implementing a change in birthing positions in our clinics we need to review evidences available and context valid related to duration of second stage of labor and birthing positions. Therefore this review aimed to examine the effect of maternal flexible sacrum birth position on duration of second stage of labor. Method The research searched articles using bibliographical Databases: Medline/PUBMED, SCOPUS, Google scholar and Google. All study designs were considered while investigating the impact of maternal flexible sacrum birthing positioning in relation duration of second stage of labor. Studies including laboring mothers with normal labor and delivery. A total of 1985 women were included in the reviewed studies. We included both qualitative and quantitative analysis. Results We identified 1680 potential citations, of which 8 articles assessed the effect of maternal upright birth positioning on the reduction during the duration of second stage of labor. Two studies were excluded because of incomplete reports for meta analysis. The result suggested a reduction in duration of second stage of labor among women in a flexible sacrum birthing position, with a mean duration from 3.2–34.8. The pooled weighted mean difference with random effect model was 21.118(CI: 11.839–30.396) minutes, with the same significant heterogeneity between the studies (I2 = 96.8%, p < 000). Conclusion The second stage duration was reduced in cases of a flexible sacrum birthing position. Even though the reduction in duration varies across studies with considerable heterogeneity, laboring women should be encouraged to choose her comfortable birth position. Researchers who aim to compare different birthing positions should consider study designs which enable women to choose birthing position. Prospero registration number [CRD42019120618]

Causes of Child Adoption in Taiwan, 1906-1940: The Importance of Gender, Household Composition and Variation over Time and Place

Adoption has been an important historical Eastern Asian family strategy to ensure family continuity. Adopting children out of the household can, however, also be seen as a strategy for dealing with excess children. This topic is the focus of our article, which investigates who was given away for adoption and why in Taiwan during the period 1906-1940. The Taiwan Historical Household Register Database (THHRD), which can take changing household composition over time into account, is analysed using univariate and Cox proportional-hazard analyses. Results demonstrate that gender, birth position among siblings of the same sex, and variation across place and time are the most important factors explaining the likelihood of being adopted for all children. Socio-economic position also played an important role and the presence of a grandfather and grandmother lowered the likelihood of being adopted especially for boys, while only the presence of a grandmother had the same effect for girls. Moreover, when looking more specifically at adoption risks for girls, the age, gender and adoption status of siblings in the household seem to matter as well, as similarly aged young siblings of either sex increased the likelihood of being adopted for girls. These findings underscore that household decision making regarding adoption is more complex than simply giving away later-born children and that it is important to also pay more attention to the reasons and motivation of households in giving away children for adoption. It provides a broader perspective on adoption practices and how children were circulated from households with too many to those with too few and how this benefitted both kinds.

Effect of maternal birth positions on duration of second stage of labor: Systematic review and meta-analysis

Abstract Background: it is believed that giving birth in an upright position is beneficial for both mother and the infant for several physiologic reasons. An upright positioning helps the uterus to contract more strongly and efficiently, the baby gets in a better position and thus can pass through the pelvis faster. Upright and lateral positions enables flexibility in the pelvis and facilitates the extension of the outlet. Before implementing a change in birthing positions in our clinics we need to review evidences available and context valid related to duration of second stage of labor and birthing positions. Objective: The aim of this review was to examine the effect of maternal flexible sacrum birth position on duration of second stage of labor. Method: The research searched articles using bibliographical Databases: Medline/PUBMED, SCOPUS, Google scholar and Google. All study designs were considered while investigating the impact of maternal flexible sacrum birthing positioning in relation duration of second stage of labor. Studies including laboring mothers with normal labor and delivery. A total of 1,985 women were included in the reviewed studies. We included both qualitative and quantitative analysis. Results: We identified 1,680 potential citations, of which 8 articles assessed the effect of maternal upright birth positioning on the reduction during the duration of second stage of labor. Two studies were excluded because of incomplete reports for meta analysis. The result suggested a reduction in duration of second stage of labor among women in a flexible sacrum birthing position, with a mean duration from 3.2-34.8. The pooled weighted mean difference with random effect model was 21.118(CI: 11.839-30.396) minutes, with the same significant heterogeneity between the studies (I 2 =96.8%, p<000). Conclusion: The second stage duration was reduced in cases of a flexible sacrum birthing position. Even though the reduction in duration varies across studies with considerable heterogeneity, laboring women should be encouraged to choose her comfortable birth position. Researchers who aim to compare different birthing positions should consider study designs which enable women to choose birthing position. Prospero registration number [CRD42019120618] Keywords: maternal position, flexible sacrum position, second stage duration

Effect of maternal birth positions on duration of second stage of labor: Systematic review and meta-analysis

Background: it is believed that giving birth in an upright position is beneficial for both mother and the infant for several physiologic reasons. An upright positioning helps the uterus to contract more strongly and efficiently, the baby gets in a better position and thus can pass through the pelvis faster. Upright and lateral positions enables flexibility in the pelvis and facilitates the extension of the outlet. Before implementing a change in birthing positions in our clinics we need to review evidences available and context valid related to duration of second stage of labor and birthing positions. Objective: The aim of this review was to examine the effect of maternal flexible sacrum birth position on duration of second stage of labor. Method: The research searched articles using bibliographical Databases: Medline/PUBMED, SCOPUS, Google scholar and Google. All study designs were considered while investigating the impact of maternal flexible sacrum birthing positioning in relation duration of second stage of labor. Studies including laboring mothers with normal labor and delivery. A total of 1,985 women were included in the reviewed studies. We included both qualitative and quantitative analysis. Results: We identified 1,680 potential citations, of which 8 articles assessed the effect of maternal upright birth positioning on the reduction during the duration of second stage of labor. Two studies were excluded because of incomplete reports for meta analysis. The result suggested a reduction in duration of second stage of labor among women in a flexible sacrum birthing position, with a mean duration from 3.2-34.8. The pooled weighted mean difference with random effect model was 21.118(CI: 11.839-30.396) minutes, with the same significant heterogeneity between the studies (I2=96.8%, p<000). Conclusion: The second stage duration was reduced in cases of a flexible sacrum birthing position. Even though the reduction in duration varies across studies with considerable heterogeneity, laboring women should be encouraged to choose her comfortable birth position. Researchers who aim to compare different birthing positions should consider study designs which enable women to choose birthing position. Prospero registration number [CRD42019120618]

Women’s Experience of Facility-Based Childbirth Care and Receipt of an Early Postnatal Check for Herself and Her Newborn in Northwestern Tanzania

Negative experiences of care may act as a deterrent to current and/or future utilization of facility-based health services. To examine the situation in Tanzania, we conducted a sub-analysis of a cross-sectional household survey conducted in April 2016 in the Mara and Kagera regions of Tanzania. The sample included 732 women aged 15–49 years who had given birth in a health facility during the previous two years. Log binomial regression models were used to investigate the association between women’s experiences of care during childbirth and the receipt of early postnatal checks before discharge. Overall, 73.1% of women reported disrespect and abuse, 60.1% were offered a birth companion, 29.1% had a choice of birth position, and 85.5% rated facility cleanliness as good. About half of mothers (46.3%) and newborns (51.4%) received early postnatal checks before discharge. Early postnatal checks for both mothers and newborns were associated with no disrespect and abuse (RR: 1.23 and 1.14, respectively) and facility cleanliness (RR: 1.29 and 1.54, respectively). Early postnatal checks for mothers were also associated with choice of birth position (RR: 1.18). The results suggest that a missed opportunity in providing an early postnatal check is an indication of poor quality of the continuum of care for mothers and newborns. Improved quality of care at one stage can predict better care in subsequent stages.

HUBUNGAN POSISI MENERAN DENGAN RUPTUR PERINEUM PADA IBU BERSALIN

ABSTRAKKematian Ibu di Indonesia dapat terjadi pada masa persalinan diantaranya disebabkan karena ruptur perineum. Beberapa faktor yang dapat menyebabkan ruptura perineum antara lain posisi persalinan, cara meneran, pimpinan persalinan dan berat bayi saat lahir. Tujuan penelitian ini adalah untuk mengetahui Hubungan Posisi Meneran dengan Ruptur Perineum di BPM Suwinah Silem Teras Boyolali. Penelitian ini menggunakan desain penelitian observasional analitik dengan pendekatan cross sectional. Populasi penelitian yaitu ibu bersalin sebanyak 32 orang, teknik sample menggunakan total sampling. Alat ukur dengan ceck list. Uji statistik chi square.Hasil : Posisi meneran antara posisi bukan setengah duduk (miring, telentang, lithotomi) dan setengah duduk sama banyaknya (50%). Kejadian ruptur perineum lebih banyak terjadi pada ibu dengan posisi persalinan bukan setengah duduk (miring, telentang dan lithotomi) (56,3%). Hasil uji chi square diperoleh nilai ρ = 0,033. Simpulan : Posisi Meneran mempunyai hubungan yang signifikan dengan Ruptur Perineum di BPM Suwinah Teras Boyolali. Kata kunci : Posisi Meneran, Ruptur PerineumKata kunci : Ruptur perineum, Posisi meneran THE RELATIONSHIP OF BIRTH POSITION WITH A RUPTURED PERINEUM AT THE BIRTHING MOTHERABSTRACTMaternal Mortality in Indonesia can be occurs during labor process, which are caused of bleeding from the perineal lacerations. Several factors what can be causing the laceration of the perineal are a wrong birth position, how mothers pushing, how midwives guiding the birth process, and babies terjadi birth weight. The purpose of this study is to identify the correlation between birth position with perineal laceration in BPM Suwinah Silem Teras Boyolali. This study is an analytic-observational designs with cross sectional approach. Total sampling were used to get sample from 32 populations of women to give birth. Check list were used to observe the birth position and perineal laceration and Chi square statistical test to analized the correlation between variables. Resuld: there are fifty-fifty between the birth position (semi seated position and others like sideways, recumbent and lithotomi) that choosed by the women during birth. Perineal lacerations are more occur at the birth position others like sideways, recumbent and lithotomi (56,3%), with P value = 0.033. Conclusion: birth position have a significant correlation with perineal laceration especially at the woman that give birt in BPM Suwinah Teras Boyolali. Keywords: birth position, perineal laceration