Tuesday, 28 June 2016

Research shows Pool Births are the Best.

Study confirms… Women who labour in water have lower rate of epidural analgesia


23 June 2016: K.D. Brainin
Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia (cervix not opening) in first stage of labour
To evaluate the impact of labouring in water during first stage of labour on rates of epidural analgesia and operative delivery in nulliparous women with dystocia.
Design Randomised controlled trial.
Setting University teaching hospital in southern England.
Participants 99 nulliparous women with dystocia in active labour at low risk of complications.
Interventions Immersion in water or standard augmentation for dystocia (amniotomy and intravenous oxytocin).
Main outcome measures:
Primary: epidural analgesia and operative delivery rates.
Secondary: augmentation rates with amniotomy and oxytocin, length of labour, maternal and neonatal morbidity including infections, maternal pain score, and maternal satisfaction with care.
Women randomised to immersion in water had a lower rate of epidural analgesia than women allocated to augmentation (47% v 66%, relative risk 0.71 (95% confidence interval 0.49 to 1.01), number needed to treat for benefit (NNT) 5).
They showed no difference in rates of operative delivery (49% v 50%, 0.98 (0.65 to 1.47), NNT 98), but significantly fewer received augmentation (71% v 96%, 0.74 (0.59 to 0.88), NNT 4) or any form of obstetric intervention (amniotomy, oxytocin, epidural, or operative delivery) (80% v 98%, 0.81 (0.67 to 0.92), NNT 5).
Labouring in water under midwifery care may be an option for slow progress in labour, reducing the need for obstetric intervention, and offering an alternative pain management strategy.
(Extract from abstract of Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia in first stage of labour by Elizabeth R Cluett, Ruth M Pickering, Kathryn Getliffe, Nigel James, St George Saunders published in British Journal of Midwfery January 26, 2004)

Women who receive less medical intervention generally stay in hospital for a shorter period of time.
The combination of an intervention free birth – with a short hospital stay result in a better experience for mother and baby.
Hospital staff and resources can be employed more efficiently.
Importantly – this results in significant financial savings!
A birth pool is a simple, inexpensive piece of equipment that can make a major impact on the quality of care and cost of having a baby.
The experience of hospitals who have birth pools shows that the cost of installing a pool is soon recouped by savings achieved through the reduced use medical methods of pain relief and intervention and shorter hospital stays.

Pain Free Labour Books now available from Amazon

Thursday, 16 June 2016

Avoiding Induction Of Labour

One of the main reasons that women are unable to give birth on their local birth center is that they go past their due date and face Induction Of Labour (IOL). This is usually offered when you are 10, 11 or 12 days past your date. Women undergoing IOL are not usually allowed on birth centers due to the extra risk to baby from a speeded up labour where baby may become distressed. This risk can result from the hormone pessaries used to initially soften and open your cervix or from the hormone drip that makes the contractions stronger and more frequent.

Researchers have found a very surprising way to try and avoid IOL. They recommend women start eating date fruit four weeks before their due date and have had some encouraging results.

The research was carried out at Jordan University of Science and Technology in 2008. Women were asked to eat SIX dates per day four weeks before they were due till they were in labour. They had a control group who did not eat any dates at all.

The women who ate the dates were more dilated when presenting in labour. On averate 4cm compared to 2cm. Intact membranes where more common amongst the date eaters, 83% vs 60%. As you know from reading this blog it is better for a pain free labour if your membranes remain intact untill you are ready to push.

Spontaneous labour occurred in 96% of those eating the dates compared with 79% who did not get a date. Use of the drip to speed up labour was only 28% in the date group and a very significant 47% in the control group.

Early labour was shorter in the date group and the researchers concluded that the consuption of date fruit in the last four weeks of pregnancy significantly reduced the need for IOL. So, in the interests of science I bought a bag of ready to eat dates to see what they tasted like. I liked them and am currently eating one a day to use them up. Not sure I could eat 6 a day, would have to cut them up and put them on porridge or have them with ice cream. But, what the heck, who cares what they taste like as long as they work.

Let me know how you get on. x :-Q

Ref: Al-Kuran O, Al-Mehaisen L, Bawadi H, Beitawi S, Amarin Z. (2011) The Effect of Late Pregnancy Consumption of Date Fruit on Labour and Delivery. Journal of Obstetrics and Gynaecology 31(1) page 29-31.

Pain Free Labour books now available from Amazon.