Enemas during labour

Revéiz, Ludovic; Gaitán, Hernando; Cuervo, Luis Gabriel

doi:10.1002/14651858.cd000330.pub3

Cited by 19 publications

(6 citation statements)

References 18 publications

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“…For example, routine episiotomy is linked to more frequent posterior perineal trauma and suturing [ 24 ] and this might deter women from seeking institutional delivery. Similarly, routine pubic shaving and enema during labour are unnecessary and make the experience of childbirth unpleasant for women [ 22 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Adherence to evidence based care practices for childbirth before and after a quality improvement intervention in health facilities of Rajasthan, India

Iyengar

Jain²,

Thomas

et al. 2014

BMC Pregnancy Childbirth

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BackgroundAfter the launch of Janani Suraksha Yojana, a conditional cash transfer scheme in India, the proportion of women giving birth in institutions has rapidly increased. However, there are important gaps in quality of childbirth services during institutional deliveries. The aim of this intervention was to improve the quality of childbirth services in selected high caseload public health facilities of 10 districts of Rajasthan. This intervention titled “Parijaat” was designed by Action Research & Training for Health, in partnership with the state government and United Nations Population Fund.MethodsThe intervention was carried out in 44 public health facilities in 10 districts of Rajasthan, India. These included district hospitals (9), community health centres (32) and primary health centres (3). The main intervention was orientation training of doctors and program managers and regular visits to facilities involving assessment, feedback, training and action. The adherence to evidence based practices before, during and after this intervention were measured using structured checklists and scoring sheets. Main outcome measures included changes in practices during labour, delivery or immediate postpartum period.ResultsUse of several unnecessary or harmful practices reduced significantly. Most importantly, proportion of facilities using routine augmentation of labour reduced (p = 0), episiotomy for primigravidas (p = 0.0003), fundal pressure (p = 0.0003), and routine suction of newborns (0 = 0.0005). Among the beneficial practices, use of oxytocin after delivery increased (p = 0.0001) and the practice of listening foetal heart sounds during labour (p = 0.0001). Some practices did not show any improvements, such as dorsal position for delivery, use of partograph, and hand-washing.ConclusionsAn intervention based on repeated facility visits combined with actions at the level of decision makers can lead to substantial improvements in quality of childbirth practices at health facilities.

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Section: Introductionmentioning

confidence: 99%

Adherence to evidence based care practices for childbirth before and after a quality improvement intervention in health facilities of Rajasthan, India

Iyengar

Jain²,

Thomas

et al. 2014

BMC Pregnancy Childbirth

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“…Hay varios ensayos clínicos realizados en Reino Unido, Francia, EE.UU, Brasil, Australia, China, en la que se estudiaron 2503 mujeres, se evaluaron en posición erguidas y ambulatorias sin analgesia epidural, arrojaron que la duración de la primera etapa del trabajo de parto fue en promedio de 1,36 horas más corta (IC 95 % -2.22 a -0.51) comparadas con quienes tenían posiciones en decúbito y supina 26,27 . Según el reporte del trabajo realizado por Iglesias, et al 28 30 . En nuestro estudio esta práctica solo se realizó en el 2,7 % de los partos.…”

Section: Discussionunclassified

“…[25][26][27][28][29][30][31][32] años. La estadística descriptiva para variables materno neonatales se muestra en la Estadística descriptiva para variables materno neonatales.Según las recomendaciones de la OMS, para la atención del parto humanizado, aún no se les permite acompañante durante la atención 85,9 %, la proporción de cesáreas fue de 34,8 %, se realizó episiotomía en un16,8 %.…”

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Adherencia a las recomendaciones de la OMS en la atención del parto y nacimiento humanizado. Medellín, Colombia

Jiménez-Hernández

Peña-Jaramillo

2018

revsal

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Objetivo: Describir el grado de adherencia del personal sanitario a las recomendaciones de la Organización Mundial de la Salud en la atención del parto y nacimiento humanizado en Medellín, Colombia. Métodos: Estudio descriptivo de corte transversal, se estudiaron 256 partos atendidos en tres instituciones de tercer nivel en Medellín y Rionegro Antioquia (abril-diciembre 2016), se incluyeron las gestantes que ingresaron en etapa del trabajo de parto, los datos se obtuvieron a partir de observación directa y aplicación de lista de chequeo de las recomendaciones de la OMS. Para el análisis de la información se aplicó estadística descriptiva, y para el análisis bivariado la prueba Chi cuadrado. Resultados: La proporción de cesárea fue elevada 34.8 %; no hubo diligenciamiento del partograma en 29,3 %; se viola la privacidad de las mujeres 26.2 %; no hubo facilidades para la deambulación 92.2 %; sigue presentándose el uso de fórceps, aunque en baja proporción 7.4 %; se realizó episiotomía en el 16.8 % de los partos. Conclusiones: El grado de adherencia por parte de las instituciones y el personal de salud que participa durante el proceso de atención del trabajo de parto, parto y del recién nacido están alejadas a las recomendaciones propuestas por la OMS.

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“…Whilst the uptake of EBM within a maternity care context was slow, some successes concern more appropriate and sophisticated treatments for women with pre‐existing health morbidities such as diabetes and cardiac complaints (Enkin, Glouberman, Groff, Jadad, & Stern, ). EBM has been responsible, through identifying a lack of evidence, for changes to a number of unnecessary care practices, such as perineal shaving (Basevi & Lavender, ), over use of cardiotocography (monitoring the foetus in labour; Alfirevic, Gyte, Cuthbert, & Devane, ) and routine use of enemas (Reveiz, Gaitán, & Cuervo, ).…”

Section: The Premise and Reality Of Evidence‐based Medicinementioning

confidence: 99%

Phenomenology as a political position within maternity care

Thomson

Crowther

2019

Nursing Philosophy

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In this article, the authors use the context of childbirth to consider the power that is endemic in certain forms of evidence within maternity care research. First, there is consideration of how the current evidence hierarchy and experimental‐based studies are the gold standard to determine and direct women's maternity experiences, although this can be at the detriment of care and irrespective of women's needs. This is followed by a critique of how the predominant means to assess women's experiences via satisfaction surveys is of limited utility, offering impartial and restricted insights to assess the quality of care provision. A counter position of hermeneutic phenomenology as research method is then described. This approach offers an alternative perspective by penetrating the taken‐for‐granted ordinariness of an event (such as childbirth) to elicit rich emic meanings. Whilst all approaches to understanding maternity care have a place, depending on the question(s) being asked, the contribution of phenomenology is how it can uncover a depth of contextual understanding into what matters to women and to inform and transform care delivery.

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Enemas during labour

Cited by 19 publications

References 18 publications

Adherence to evidence based care practices for childbirth before and after a quality improvement intervention in health facilities of Rajasthan, India

Adherence to evidence based care practices for childbirth before and after a quality improvement intervention in health facilities of Rajasthan, India

Adherencia a las recomendaciones de la OMS en la atención del parto y nacimiento humanizado. Medellín, Colombia

Phenomenology as a political position within maternity care

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