Sensitive Midwifery - Issue 43 - July2019

Birth review Birth Safer home births with standardised bags A UK mother and baby charity, Baby Lifeline, has worked to develop a standardised equipment bag for community midwives attending home births. The rucksack-style bag contains everything they may need, including emergency equipment. Follow the link to find out more. Betteley, C, ‘Home births: Community midwives trial “delivery bags”. Available: https://www.bbc.com/news/uk-wales-47452372 Woman-centred care linked to fewer second-degree tears A study from Sweden looked at strategies care providers can use in the second stage of labour to improve health outcomes. Midwives treated 296 first-time mothers with a three-part protocol called ‘woman-centred care’ and 301 first-time mothers with standard care. The group that received woman- centred care used spontaneous pushing (pushing efforts were not coached or directed); flexible sacrum birthing positions (kneeling, standing, hands-and- knees, side-lying, birth seat); and birth of the baby’s head and shoulders in two separate contractions. The midwives who practised standard care didn’t receive any special instructions. The researchers determined that the odds of second- degree tears were less likely in the people who received woman-centred care compared to those who received standard care. However, since this was a three-part protocol, it’s not known which part of the protocol contributed to the fewer second-degree tears. Sensitive Midwifery imagines that any and all woman-centred care will improve birth outcomes, including the incidence of perineal tearing! Edqvist, M, et al, ‘Birth. Midwives’ management during the second stage of labor in relation to second-degree tears – an experimental study’, Birth , 2017, 44(1), 86-94 8 Remedies and a topical oil, to facilitate a healthy pregnancy term, ease the labour process and enhance recovery in both natural birth and caesarian section. MATERNITY /LABOUR KIT tel: 021 712 0324 • email: info@pegasuskits.com www.pegasuskits.com Don’t go with the ‘ARRIVE trial’ A 2018 article about ‘A Randomized Trial of Induction Versus Expectant Management’, also referred to as the ‘ARRIVE trial’, claims that induction of labour at 39 weeks has better outcomes for mother and baby compared to going into labour naturally. This is despite findings and recommendations to the contrary by none less than the University of Copenhagen (specifically about timing of induction) and the American College of Obstetricians and Gynaecologists (regarding updated classification of gestational full term). Low-risk births have better outcomes when they are allowed to proceed with minimal medical intervention. Take care not to fall into the trap of medicalising the birth process and changing protocols based on one-sided research. • Cohain, JS, ‘More evidence to avoid hospital birth: a critique on the results of the arrive study’. Available: https://midwiferytoday. com/mt-articles/more-evidence-to-avoid-hospital-birth/ • The American College of Obstetricians and Gynaecologists Committee on Obstetric Practice & Society, ‘Definition of Term Pregnancy’, 2013 (reaffirmed 2017). Available: https://www.acog . org/Clinical-Guidance-and-Publications/Committee-Opinions/ Committee-on-Obstetric-Practice/Definition-of-Term-Pregnancy 15