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Created on : 10 May 2007
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Best practices in second stage labor care: maternal bearing down and positioning. J Midwifery Womens Health. 2007 May-Jun;52(3):238-45

Author(s) :

Roberts J, Hanson L.

Year of publication :


URL(s) :…

Résumé (français)  :

Bien que la nocivité des efforts poussé soutenue soit prouvée pour les résultats sur la mère et le foetus, les pratiques médicales sont toujours caractérisées par les instructions de pousser fortement à la dilatation complète du col de l’utérus alors que la mère en position couchée. La poussée dirigée peut réduire légèrement la durée du second stade du travail, mais elle contribue aussi à la [désoxygénation?] du foetus, endommager les structures urinaires, pelviques et périnéales, et remttre en cause la confiance que la femme accorde à son corps. Ceci est une revue de la recherche sur le second stade du travail s’intéressant à la littérature récente traitant des efforts de poussée, l’approche [laboring down] des soins, la durée du second stade et les positions maternelles [à finir]

Abstract (English)  :

Despite evidence of adverse fetal and maternal outcomes from the use of sustained Valsalva bearing down efforts, current second-stage care practices are still characterized by uniform directions to "push" forcefully upon complete dilatation of the cervix while the woman is in a supine position. Directed pushing might slightly shorten the duration of second stage labor, but can also contribute to deoxygenation of the fetus; cause damage to urinary, pelvic, and perineal structures; and challenge a woman’s confidence in her body. Research on the second stage of labor care is reviewed, with a focus on recent literature on maternal bearing down efforts, the "laboring down" approach to care, second-stage duration, and maternal position. Clinicians can apply the scientific evidence regarding the detrimental effects of sustained Valsalva bearing down efforts and supine positioning by individualizing second stage labor care and supporting women’s involuntary bearing down sensations that can serve to guide her behaviors.

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Keywords :

➡ duration of labour ; position during labor ; perineal/vaginal tears ; incontinence/prolapsus ; fetal distress ; episiotomy ; active management of labor ; dilation

Author of this record :

Emmanuelle Phan — 10 May 2007
➡ latest update : Bernard Bel — 02 Dec 2007

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