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Edda Sveinsdottir, Helga Gottfredsdottir, Anna S Vernhardsdottir, Gudny B Tryggvadottir, Reynir T Geirsson
BACKGROUND: Obstetric anal sphincter injuries lead frequently to short- and long-term consequences for the mother, including perineal pain, genital prolapse, and sexual problems. The aim of the study was to evaluate whether the implementation of an intervention program in the second stage of labor involving altered perineal support techniques reduced severe perineal trauma. METHODS: All women reaching the second stage of labor and giving birth vaginally to singleton babies at Landspítali University Hospital (comprising 76% of births in Iceland in 2013) were enrolled in a cohort study...
November 16, 2018: Birth
Jeremy L Neal, Nicole S Carlson, Julia C Phillippi, Ellen L Tilden, Denise C Smith, Rachel B Breman, Mary S Dietrich, Nancy K Lowe
BACKGROUND: The presence of midwives in a health system may affect perinatal outcomes but has been inadequately described in United States settings. Our objective was to compare labor processes and outcomes for low-risk nulliparous women birthing in United States medical centers with interprofessional care (midwives and physicians) versus noninterprofessional care (physicians only). METHODS: We conducted a retrospective cohort study using Consortium on Safe Labor data from low-risk nulliparous women who birthed in interprofessional (n = 7393) or noninterprofessional centers (n = 6982)...
November 11, 2018: Birth
Nicole S Carlson, Jeremy L Neal, Ellen L Tilden, Denise C Smith, Rachel B Breman, Nancy K Lowe, Mary S Dietrich, Julia C Phillippi
BACKGROUND: Sixty percent of United States births are to multiparous women. Hospital-level policies and culture may influence intrapartum care and birth outcomes for this large population, yet have been poorly explored using a large, diverse sample. We sought to use national United States data to analyze the association between midwifery presence in maternity care teams and the birth processes and outcomes of low-risk parous women. METHODS: We conducted a retrospective cohort study using Consortium on Safe Labor data from low-risk parous women in either interprofessional care (n = 12 125) or noninterprofessional care centers (n = 8996)...
November 9, 2018: Birth
Emily White VanGompel, Susan Perez, Chi Wang, Avisek Datta, Valerie Cape, Elliott Main
BACKGROUND: Cesarean delivery rates in the United States vary widely between hospitals, which cannot be fully explained by hospital or patient factors. Cultural factors are hypothesized to play a role in cesarean overuse, yet tools to measure labor culture are lacking. The aim of this study was to revise and validate a survey tool to measure hospital culture specific to cesarean overuse. METHODS: A panel of clinicians and researchers compiled an item bank from validated surveys, added newly created items, and performed four rounds of iterative revision and consolidation...
November 8, 2018: Birth
Jennifer L Beauregard, Jennifer M Nelson, Heather C Hamner
BACKGROUND: Hospitals that provide maternity care can play an important role in providing or directing mothers to postdischarge breastfeeding support, which improves breastfeeding duration especially when providing multiple support modes. This study described 2007-2015 national trends in postdischarge breastfeeding supports among United States maternity care hospitals. METHODS: Data were from the Maternity Practices in Infant Nutrition and Care survey, a biennial census of maternity care hospitals in the United States and territories...
November 6, 2018: Birth
Janet E Perkins, Ahmed Ehsanur Rahman, Abu Bakkar Siddique, Mohammad Rifat Haider, Goutom Banik, Tazeen Tahsina, Shams El Arifeen
BACKGROUND: In Bangladesh, over half of women give birth at home, generally without the support of a skilled birth attendant. In this article, we examined the decision-making around birthplace and explored the reported reasons of preferring home birth over facility birth in a rural district of Bangladesh. METHODS: A cross-sectional household survey with 1367 women was conducted in Brahmanbaria district. Choice of birthplace and actual place of birth were the main outcomes of interest...
October 31, 2018: Birth
Holly Powell Kennedy, Katy B Kozhimannil, Carol Sakala
No abstract text is available yet for this article.
October 31, 2018: Birth
Charlotte Elvander, Mia Ahlberg, Malin Edqvist, Olof Stephansson
BACKGROUND: To examine risk of severe perineal trauma among nulliparous women and those undergoing vaginal birth after cesarean delivery (VBAC). METHODS: This is a population-based cohort study of all births to women with their two first consecutive singleton pregnancies in Stockholm-Gotland Sweden between 2008 and 2014. Risk of severe perineal trauma was compared between nulliparous women and those undergoing VBAC with severe perineal trauma being the main outcome measure...
October 22, 2018: Birth
Mandie Scamell, Aliyha Ghumman
BACKGROUND: Increasing numbers of childbearing women with a history of female genital mutilation (FGM) are accessing maternity services in high-income countries across the world. For many of these women, their first contact with the health services in their host country is when they are pregnant. While the clinical consequences of certain categories of FGM are well documented, how high-risk maternity services - designed to mitigate the obstetric consequences of FGM - impact upon women's experience of childbearing is less clear...
October 7, 2018: Birth
Zan Zheng, GuoHong Xie, Tubao Yang, Jiabi Qin
BACKGROUND: The association between active maternal smoking and congenital malformations is well established, but little is known about the association between secondhand smoke and congenital malformations. Moreover, studies regarding the association between congenital malformations and secondhand smoke have not yielded consistent results. METHODS: In July 2018, we searched PubMed, EMBASE, and China Biology Medicine databases for observational studies characterizing the relationship between secondhand smoke and congenital malformations of offspring in nonsmoking women...
October 3, 2018: Birth
Oana Anton, Harriet Jordan, Heike Rabe
BACKGROUND: Enhanced placental transfusion reduces adverse neonatal outcomes, including death. Despite being endorsed by the World Health Organization in 2012, the method has not been adopted widely in practice. METHODS: We performed a systematic literature search and included quality improvement projects on placental transfusion at birth and studies on barriers to implementation. We extracted information on population, methods of implementation, obstacles to implementation, and strategies to overcome them...
September 27, 2018: Birth
Katherine H Campbell, Jessica L Illuzzi, Henry C Lee, Haiqun Lin, Heather S Lipkind, Lisbet S Lundsberg, Christian M Pettker, Xiao Xu
BACKGROUND: This study aims to examine hospital variation in both maternal and neonatal morbidities and identify institutional characteristics associated with hospital performance in a combined measure of maternal and neonatal outcomes. METHODS: Using the California Linked Birth File containing data from birth certificate and hospital discharge records, we identified 1 322 713 term births delivered at 248 hospitals during 2010-2012. For each hospital, a risk-standardized rate of severe maternal morbidities and a risk-standardized rate of severe newborn morbidities were calculated after adjusting for patient clinical risk factors...
September 24, 2018: Birth
Rose Coates, Lucia Rocca-Ihenacho, Ellinor Olander, Susan Ayers, Debra Salmon
BACKGROUND: Midwifery-led birth settings have been recommended as the most cost-effective birthplaces for healthy women experiencing uncomplicated pregnancies. However, midwives complete most of their training in obstetric units where birth interventions are common. To prepare for working in a midwifery-led setting training is a key priority. This study evaluated a postgraduate-level midwifery module on Optimum Birth (defined as birth which supports physiology and empowerment, avoiding unnecessary intervention) designed to prepare midwives for supporting women in midwifery-led settings...
September 21, 2018: Birth
Mei-Chen Du, Yan-Qiong Ouyang, Xiao-Fei Nie, Yi Huang, Sharon R Redding
BACKGROUND: Overweight and obesity are related to maternal and infant physical health, such as gestational diabetes, preeclampsia, and macrosomia. The purpose of this meta-analysis was to assess the effect of physical exercise on maternal and infant outcomes in overweight and obese pregnant women. METHODS: Two researchers independently searched Cochrane Library, Embase, PubMed, Web of Science, and for English-language articles based on randomized controlled trials examining physical exercise in overweight and obese pregnant women and its effect on maternal and infant outcomes...
September 21, 2018: Birth
Minh N Nguyen, Mohammad Siahpush, Brandon L Grimm, Gopal K Singh, Melissa K Tibbits
BACKGROUND: Racial or ethnic and socioeconomic disparities in adverse birth outcomes are well known, but few studies have examined disparities in the receipt of prenatal health education. The objectives of this study were to examine racial or ethnic and socioeconomic variations in receiving (1) comprehensive prenatal health education and (2) education about human immunodeficiency virus (HIV) testing, breastfeeding, alcohol, and smoking cessation from health care practitioners. METHODS: Data were drawn from the 2012 to 2014 Pregnancy Risk Assessment Monitoring System (PRAMS)...
September 14, 2018: Birth
Jonathan K L Mak, Andy H Lee, Ngoc Minh Pham, Xiong-Fei Pan, Li Tang, Colin W Binns, Xin Sun
BACKGROUND: Few studies have examined the age-standardized incidence of gestational diabetes mellitus (GDM) for comparison between populations. Information on delivery outcomes is also lacking for Chinese women with GDM. Therefore, the present study aimed to determine age-standardized GDM incidence and assess its association with maternal and neonatal outcomes. METHODS: A total of 1901 pregnant women were recruited in Chengdu, Sichuan Province. GDM was diagnosed between 24 and 28 weeks' gestation using oral glucose tolerance tests...
September 14, 2018: Birth
Meliha Salahuddin, Dorothy J Mandell, David L Lakey, Catherine S Eppes, Divya A Patel
BACKGROUND: Cesarean delivery accounts for over one-third of the ~400 000 annual births in Texas, with first-time cesarean accounting for 20% of the overall cesareans. We examined associations of maternal medical comorbidities with cesarean delivery among nulliparous, term, singleton, vertex (NTSV) deliveries in Texas. METHODS: Nulliparous, term, singleton, vertex deliveries to women aged 15-49 years were identified using the 2015 Texas birth file (Center for Health Statistics, Texas Department of State Health Services)...
September 9, 2018: Birth
Roa Altaweli, Christine McCourt, Mandie Scamell, Katherine Curtis Tyler
BACKGROUND: Routine use of medical interventions during labor has been identified as a clinical area for concern, since such routinized practice is not consistent with an evidence-based approach to care and continues to increase despite efforts to encourage normal childbirth. Therefore, the aim of our study was to explore maternity health professionals' use of interventions during the second stage of labor in two hospitals in Jeddah, Saudi Arabia, to understand what influences their decision-making and practices...
September 9, 2018: Birth
Kathleen C Parry, Kristin P Tully, Lorenzo N Hopper, Paige E Schildkamp, Miriam H Labbok
BACKGROUND: Comprehensive prenatal education on infant feeding is recommended by many United States health organizations because of the need to maximize maternal preparedness for managing lactation physiology. Ready, Set, BABY (RSB) is a curriculum developed for counseling women about breastfeeding benefits and management including education on optimal maternity care practices. We hypothesized that RSB would be acceptable to mothers and that mothers' strength of breastfeeding intentions would increase, and their comfort with the idea of formula feeding would decrease after educational counseling using the materials...
September 6, 2018: Birth
Elizabeth Rose Hansen, Aimee R Eden, Lars E Peterson
BACKGROUND: Family Medicine-Obstetrics fellowships provide family physicians with advanced obstetrics training. No accreditation system exists for these fellowships, which leads to variable training. Variation of fellows' experiences is not well understood. Our objective is to understand the motivations, training, and overall experiences of fellows in Family Medicine-Obstetrics fellowships, which may inform opportunities for improvement in fellowship design and suggest how Family Medicine-Obstetrics fellowship-trained physicians are prepared to practice among other obstetrics providers postgraduation...
September 6, 2018: Birth
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