Identification of maternal characteristics associated with the use of epidural analgesia
ABSTRACT The present survey aims to identify predictors associated with the use of epidural analgesia (EA). Therefore, from October 2007 to June 2008, a survey was conducted in 193 pregnant women (mean age 31.7 years (SD 4.9); 64.8% primipara) attending a German general hospital with a specialisation in integrative medicine. Questionnaires, including Antonovsky's sense of coherence (SOC) were delivered antepartum. Delivery data were recorded within the hospital quality management programme. The adjusted odds ratio (OR) for EA use was significantly greater than one for women who had previously used EA (adjusted OR =4.1; CI: 1.03-16.31) and for the desire for a delivery without pain (adjusted OR =3.05; CI: 1.36-6.83). The likelihood of EA use decreased in multipara (adjusted OR =0.05; CI: 0.01-0.22). SOC was not found to be an independent predictor for EA use. However, women with high SOC more often preferred a delivery without EA (p for trend =0.037). In conclusion, first time labour, the desire for a delivery without pain and previous use of EA are independent predictors for the use of EA in labour. Further studies should clarify the predictive role of SOC in pregnancy.
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ABSTRACT: the aim of this study is to gain a deeper understanding of a woman׳s internal factors and factors in her environment that are important for a normal birth and a positive birth experience. a qualitative approach was selected for data collection, and the data presented are derived from in-depth interviews. Twelve healthy first time Norwegian mothers, aged 22-34, with a normal childbirth and a positive birth experience were interviewed five to six weeks after giving birth. All participants had given birth at a maternity unit, where 4000 births take place per year. The transcribed interviews were analysed through systematic text condensation. the findings included two main themes: safe environment and emotional strength. Stability in everyday life and close relationships provided the women with the safe environment they needed. The women had a positive attitude to childbirth and they had all previously developed coping strategies. They highlighted that these acquired coping strategies contributed to higher emotional strength and a positive birth experience. the women experienced that a safe environment and network contributed to a sense of trust and emotional strength, which were positive factors promoting a normal birth and a positive birth experience. The women had a positive attitude towards the birth and used acquired coping strategies to deal with it, which in turn led to a positive birth experience. The natural vision the women had in connection with childbirth was part of their antenatal preparation, which also contributed to a positive experience of childbirth. Copyright © 2015 Elsevier Ltd. All rights reserved.Midwifery 04/2015; DOI:10.1016/j.midw.2015.03.016 · 1.71 Impact Factor
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ABSTRACT: Background Health care outcomes used in service evaluation and research tend to measure morbidity and mortality. This is the case even in maternity care, where most women and babies are healthy. Salutogenesis theory recognises that health is a continuum, with explicit inclusion of wellbeing as well as illness and pathology. This offers the potential to reframe the outcomes and therefore, the focus of, maternity care research and provision. Aim The aim of this study was to identify how salutogenesis has been defined and used in maternity care research undertaken with healthy women. Method A scoping review was undertaken, using a formal pre-defined search strategy. Inclusion criteria encompassed research papers relating to the maternity episode up to one year after birth, using salutogenesis or any of its associated concepts, focused on healthy women, and written in a language which any of the members of the group could understand. The search was undertaken in two phases (Database inception-April 2011 and May 2011 -February 2013). Included studies were subject to narrative analysis. Findings Eight papers met the inclusion criteria. They covered seven topics, spanning the antenatal, intrapartum and postnatal periods. Only two papers employed both positive health orientation and explicit use of Antonovsky's theory. The remaining studies used discrete aspects of the theory. Conclusion Salutogenic framing is rarely used in maternity care research with healthy participants. An increase in research that measures salutogenically orientated outcomes could, eventually, provide a balance to the current over-emphasis on pathology in maternity care design and provision worldwide.Sexual & reproductive healthcare: official journal of the Swedish Association of Midwives 09/2014; 6(1). DOI:10.1016/j.srhc.2014.09.001 · 1.25 Impact Factor
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ABSTRACT: In this study we aimed to explore the effects of epidural analgesia achieved by a combination of low-dose bupivacaine and fentanyl infused through an epidural catheter on mother, foetus and labour process in nulliparous at-term pregnant women during vaginal delivery. This study was designed in a prospective, randomised controlled manner. Epidural analgesia was achieved in 50 nulliparous women. Fifty nulliparous women did not undergo epidural analgesia procedure. The duration of the first stage of labour was significantly shortened, while the second stage was significantly lengthened in pregnant women who underwent epidural analgesia (p < 0.05). In conclusion, starting epidural analgesia application during the active phase of the first stage of labour may shorten the duration of the first stage compared with the group of nulliparous women not undergoing epidural analgesia. The factor that has an impact on this may be the addition of fentanyl to bupivacaine used for epidural analgesia.Journal of Obstetrics and Gynaecology 12/2014; DOI:10.3109/01443615.2014.991299 · 0.60 Impact Factor