1A. Consider all birthplace options, recognizing that birth experiences are enhanced in home, birth center, or hospital settings that support parent's informed choices for the labor, birthing, and postpartum process.
References:
Abstract 1:
Premise: A women’s expectation of the labor and delivery nurse regarding partner involvement during the birthing process varies and needs to be taken into consideration when providing care to a mother in labor.
Research Questions: How do women define their expectations of nursing care during labor and delivery? If met, how do these expectations influence women’s levels of satisfaction with their care and with the overall childbirth experience? Were women’s expectations met?
Background: Previous research suggests that positive childbirth experiences could be consistently maintained if the professional’s and client's role expectations were congruent.
Subjects: A total of 61 married, low-risk multigravidae attending a series of Lamaze classes with their husbands who were planning to give birth in a 400-bed hospital.
Study Design: Information was collected from 61 married, low-risk multigravidae women at 36-38 weeks gestation. The women were interviewed in semi-structured, tape-recorded, in-depth interviews comprised of open-ended questions. The open-ended questions were designed to elicit each woman’s expectations of the labor and delivery nurse during labor and delivery.
Findings: Based on this study, the women were separated into three groups. The first group (17 women) desired limited nurse involvement. These women wanted high partner involvement. They largely wanted nurses to leave them alone with their husbands, with the exception of essential care. Also, they only wanted the nurses to examine them when the mothers believed they needed to be examined. The second group (22 women) reported wanting more nurse involvement. These women wanted the nurses to give them ample time alone with their partners, helping their husbands as needed. The third group (22 women) reported wanting extensive nurse involvement. These women wanted the nurse to be fully involved in the birth process. In this study, the participants saw the nurse’s most important role as that of being aware of the maternal and fetal status.
Research reviewed by LaShontae Scott-Roberts, RNC, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.
Abstract 2:
Premise: Women in labor benefit from support from a female relative.
Research Question: Does support from a female relative provide any benefits to a laboring woman?
Variables: Maternal age, weight, height, gestation, prenatal visits, fundal height, cervical dilation, spontaneous delivery, analgesia, normal vaginal birth, and fetal heart rate per minute.
Subjects: A total of 109 black primagravida Botswana women with uncomplicated pregnancies and spontaneous labors and who presented at a major referral center in 1994. Each woman was pregnant with one fetus, between 38-42 weeks gestation with cephalic presentation, and cervix dilated between 1 and 6cm. Each woman was accompanied by a female relative.
Study Design: The experiment group received standard hospital care with the female relative present for support during the entire labor. The control group received only standard hospital care. No exclusions occurred after the selection was done.
Findings: The mothers in the experimental group had significantly higher spontaneous vaginal deliveries (91% vs. 71%), less analgesia use during labor (53% vs 73%), less oxytocin (13% vs. 30%), fewer amniotomies to augment labor (30% vs. 54%), fewer vacuum extractions (4% vs. 16%), and fewer cesarean sections (6% vs. 13%) compared to the control group.
The support of a female relative while in labor is shown to result in fewer interventions and increased frequency of normal vaginal deliveries.
Research reviewed by Rochelle Gower, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.