Perineal protection methods: knowledge and use

Martínez, Esther María López; Sáez, Zaraida Avilés; Sánchez, Encarnación Hernández; Ávila, Marcos Camacho; Conesa, Ester Marín; Ferrer, María Belén Conesa

doi:10.1590/1980-220x-reeusp-2020-0193

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…In response to the significant issues associated with perineal trauma post‐childbirth, various interventions have been implemented for prevention and minimization (Aasheim et al., 2017 ; Fretheim et al., 2013 ; Kopas, 2014 ; Marcos‐Rodríguez et al., 2023 ; Martínez et al., 2021 ). Notably, the avoidance of routine episiotomy is strongly advocated in most guidelines (World Health Organization, 2018 ), as restrictive episiotomy practices have not been linked to foetal acidosis or adverse infant outcomes (FIGO Safe Motherhood and Newborn Health (SMNH) Committee, 2012 ; Friedman et al., 2015 ; Hidalgo‐Lopezosa et al., 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Midwives' approach to the prevention and repair of obstetric perineal trauma in Spain

Laderas Díaz,

Rodríguez‐Almagro,

Picón Rodríguez

et al. 2024

Nursing Open

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AimDifferent clinical practice guidelines include recommendations on how to prevent and repair obstetric perineal trauma, as well as the use of episiotomy. To evaluate the variability in midwives' professional practices for preventing and repairing perineal trauma, as well as the professional factors that may be associated with the restrictive use of episiotomy.DesignObservational cross‐sectional study.MethodsThree hundred five midwives completed an anonymous questionnaire developed by the authors and distributed across various midwifery scientific societies. The main outcomes measured were the frequencies of adopting specific practices related to perineal injury prevention and repair, episiotomy technique and restrictive episiotomy use (<10%). Odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals were estimated.ResultsIntrapartum perineal massage was not normally used by 253 (83%) of midwives, and 186 (61%) applied compresses soaked in warm water to the perineum. Regarding episiotomy, there was a great deal of variability, noting that 129 (42.3%) adopted a restrictive use of this procedure, 125 (41%) performed it between 10% and 20%, while 51 midwives (16.7%) performed it in more than 20% of cases. In addition, 165 (54.1%) midwives followed an incision angle of 60º. Concerning tears, 155 (50.8%) usually sutured first‐degree tears and 273 (89.5%) always sutured second‐degree tears. Midwives attending home births (aOR = 6.5; 95% CI: 2.69–15.69), working at a teaching hospital (aOR = 3.69; 95% CI: 1.39–9.84), and the ones who recently completed their professional training (aOR = 3.58; 95% CI: 1.46–8.79) were significantly more likely to adopt a restrictive use of episiotomy.ConclusionsThere is a significant variability in Spanish midwives' practices for preventing and repairing perineal tears. Moreover, the restrictive use of episiotomy is associated with midwives attending home births, working in teaching hospitals and having recent professional training.Patient or Public ContributionNo patient or public contribution.

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Section: Introductionmentioning

confidence: 99%

Midwives' approach to the prevention and repair of obstetric perineal trauma in Spain

Laderas Díaz,

Rodríguez‐Almagro,

Picón Rodríguez

et al. 2024

Nursing Open

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Variability of clinical practice in the care of the second stage of labor among midwives in Spain

Díaz,

Rodriguez-Almagro,

Martinez-Galiano

et al. 2024

BMC Nurs

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Background There are recommendations based on scientific evidence on care in the second stage of labor, but it is not known to what degree the professionals comply with these recommendations. Objective The aim of this study is to examine the variability in clinical practices among midwives during the second stage of labor, including positions, mobility, practices, and the maximum time allowed before initiating active pushing, and to assess their adherence to clinical practice guidelines. Methods A cross-sectional observational study. A self-designed questionnaire was developed and distributed online through scientific societies. The main variables studied were professional and work environment characteristics, maternal positions and mobility, practices during this stage, maximum time to start active pushing and duration of the second stage of labor. Descriptive statistics were calculated using SPSS 24.0. Results Regarding the woman’s position during childbirth, 80.3% (245) of midwives frequently or always allow the woman to choose her birthing position. Furthermore, 44.6% (136) of professionals prefer using side-lying positions for the mother. Regarding drinking fluids during childbirth, 51.1% (156) of midwives allowed the woman to drink the amount of liquids she wanted, whereas 11.1% (34) said that they would allow them to do so however, this was against the protocol of their hospital. When inquiring about the Kristeller maneuver, it was reported to be excessively performed in 35.1% (107) of cases for fetal bradycardia, 33.1% (101) for maternal exhaustion, and 38.4% (117) to avoid instrumental birth. Finally, a great variability was observed in the time criteria used for the initiation of active pushing and the maximum duration of the second stage of labor. Conclusions Certain practices, such as the Kristeller maneuver, are overused among midwives, with great variability in the use of certain procedures, the waiting times to initiate pushing and completion of the second stage of labor. Further training and awareness campaigns are needed for professionals to apply evidence-based care.

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Perineal protection methods: knowledge and use

Cited by 2 publications

References 11 publications

Midwives' approach to the prevention and repair of obstetric perineal trauma in Spain

Midwives' approach to the prevention and repair of obstetric perineal trauma in Spain

Variability of clinical practice in the care of the second stage of labor among midwives in Spain

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