Study on the health and self-efficacy of pregnant women in delivery with music analgesia and labor doula / Estudo sobre a saúde e autoeficácia de gestantes no parto com analgesia induzida por música e apoio de doula / Efectos del parto en la salud y la autoestima de la mujer embarazada

ABSTRACT To explore the effect of delivery supported by a labor doula combined with music therapy on stabilizing maternal psychology and improving delivery quality, and to find out the predictors of delivery self-efficacy. Statistical processing showed that P<0.05, which was statistically significant. Group was superior in numerical value, followed by the B group. Using the rank sum test, the pain grade of the experimental group was significantly lower than that of the control group, and the difference was statistically significant (P<0.05). T test or χ2 test showed that the total labor time of the experimental group was shorter than that of the control group. Vaginal delivery rate was higher than that of the control group, and the cesarean section rate was lower than that of the control group, and the difference was statistically significant (P<0.05). Conclusion: Doula delivery combined with music therapy is effective in parturient delivery, which can alleviate parturient pain, speed up labor progress and improve delivery quality, and is worthy of popularization and application. At the same time, increasing pregnant women's understanding of delivery strategies and techniques and improving their psychological state will help improve the level of delivery self-efficacy of pregnant women.

RESUMO Explorar o efeito do parto apoiado por doulas combinado com a terapia musical em estabilizar o estado psicológico materno e melhorar a qualidade do parto, e descobrir os indicadores de autoeficácia do parto. O processamento estatístico mostrou que P<0.05, o que foi estatisticamente significativo. O Grupo foi superior em valor numérico, seguido pelo Grupo B. Por meio do teste da soma dos ranks, o grau de dor do grupo experimental foi significativamente menor do que o do grupo controle, e a diferença foi estatisticamente significativa (P<0.05). O teste de T ou teste de χ2 mostrou que o tempo de trabalho de parto total do grupo experimental foi mais curto do que o do grupo controle. A taxa de parto normal foi maior do que a do grupo, e a taxa de cesariana foi menor do que a do grupo controle, e a diferença foi estatisticamente significativa (P<0.05). Conclusão: O parto feito com doulas combinado com a terapia musical é eficaz para a parturiente, podendo aliviar a dor do parto, acelerar o trabalho de parto e melhorar a qualidade do parto, merecendo maior popularização e aplicação. Ao mesmo tempo, aumentar a compreensão das gestantes sobre estratégias e técnicas de parto e melhorar seu estado psicológico ajudará a melhorar o nível de autoeficácia do parto dessas mulheres.

RESUMEN Explorar el efecto del parto apoyado por una doula combinado con musicoterapia para estabilizar el estado psicológico materno, mejorar la calidad del parto, y descubrir los predictores de la autoeficacia del mismo. El procesamiento estadístico mostró P <0.05, lo que fue estadísticamente significativo. El grupo fue superior en valor numérico, seguido por el grupo B. Usando la prueba de la suma de rangos, el grado de dolor del grupo experimental fue significativamente más bajo que el del grupo de control, y la diferencia fue estadísticamente significativa (P <0.05). La prueba T o la prueba χ2 mostraron que el tiempo total de trabajo del grupo experimental fue más corto que el del grupo de control. La tasa de parto vaginal fue mayor que la del grupo de control, y la tasa de cesáreas fue menor que la del grupo de control, y la diferencia fue estadísticamente significativa (P <0.05). Conclusión: El parto con doulas combinado con musicoterapia es eficaz, puede aliviar el dolor de las parturientas, acelerar el progreso del parto y mejorar la calidad del mismo, y es digno de popularización y aplicación. Al mismo tiempo, aumentar la comprensión de las mujeres embarazadas sobre las estrategias y técnicas de parto y mejorar su estado psicológico ayudará a mejorar el nivel de autoeficacia del parto de las mujeres embarazadas.

Interventions to reduce caesarean section rates at government medical college and hospital Aurangabad, India

Background: Caesarean sections are effective in saving maternal and infant lives, but only when they are performed for medically indicated reasons, The Objective of this study was to reduce caesarean Section rate at GMCH, Aurangabad and to improve overall birthing experience with respectful maternity care.Methods: The caesarean sections done at GMCH Aurangabad were audited using Robson`s Ten Group classification system to identify the major contributors to the overall CS rate. The following clinical and non-clinical interventions were applied dynamically to control the caesarean section rates. Clinical Interventions were changes in protocols regarding induction of labour, Intermittent auscultation as opposed to continuous electronic foetal monitoring in low risk cases, use of a partogram, encouragement of different birthing positions, promoting TOLAC to reduce the secondary CS rate. Nonclinical interventions include encouragement of DOULA (birth companion), ante-natal counselling of the expectant mothers, training of healthcare staff for respectful maternity care and use of evidence based clinical practice guidelines with mandatory second opinion for every non recurrent indication of CS. Auditing of caesarean section using Robson classification.Results: In this study there has been steady decline in LSCS rates from 33% to 26.9%. On analysis with Robson classification, group 5 (previous LSCS) made largest contribution of 36.9% followed by Group 1, 2, 10 each contributed 18.01%,13.2% and 11.2% respectively. Group 6 to 10 account for 23%. Various birthing positions lowered use of oxytocics from 33 % to 19% as well lowered episiotomy rates with greater success in vaginal delivery.Conclusions: Modification of induction protocols have reduced the primary LSCS rates and successful VBAC using FLAMM score was helpful in reducing the repeat caesarean Sections. Various birthing positions, DOULA gave greater success in vaginal delivery. LSCS rates in mothers with breech, multiple or oblique/transverse lies were largely unmodifiable. Limiting the CS rate in low-risk pregnancies by individualizing every labour and not to set a time limit as long as mother and baby are closely monitored.

Effect evaluation of two labor analgesia methods with Doula services / 预防医学

Objective @#To evaluate the effects of transcutaneous electrical nerve stimulation ( TENS ) and waterbirth with Doula services on the outcome of delivery. @*Methods@#From July 2018 to December 2019, 150 primiparas in Hangzhou Women's Hospital were randomly divided into three groups: TENS, waterbirth and control groups. They were given TENS, waterbirth and conventional midwifery, accompanied by Doula services. The visual analogue scores ( VAS ) , length of labor stages and neonatal asphyxia were compared.@*Results@#It finally included 45 cases in the TENS group, 45 cases in the waterbirth group and 44 cases in the control group. There were no significant differences in gestational weeks, age, height, weight, fetal biparietal diameter and newborn birth weight among the three groups ( P>0.05 ) . The VAS scores of TENS group and waterbirth group were lower than those of the control group ( P<0.05 ) , but there were no significant differences between the two groups ( P>0.05 ) with the cervix open to 2.5-3 cm, 5-7 cm ( 0.5 hours later ) and 10 cm. There was no interaction between the analgesia methods and cervix diameter ( P>0.05 ) . The duration of the first stage of labor in the TENS group and the waterbirth group was less than that in the control group ( P<0.05 ) , and there was no significant difference between the TENS group and the waterbirth group ( P>0.05 ) . The asphyxia rate of neonates in TENS group, waterbirth group and control group were 2.22%, 2.22% and 4.55%, respectively, with no significant difference ( P>0.05 ) . @*Conclusion@#Under Doula services, both TENS and waterbirth can effectively relieve the pain of delivery and shorten the first stage of labor, without obvious differences.

Percepção de mulheres sobre o parto e o papel da doula / On how women perceive childbirth and the role of doula / Percepción de mujeres sobre el parto y el papel de la doula

Os cuidados oferecidos pela doula, profissional que orienta e assiste a mulher na gestação, no parto e no pós-parto, são considerados como acolhedores e tendem a promover o bem-estar emocional da parturiente, auxiliando-a no enfrentamento das situações de desconforto. O objetivo dessa pesquisa foi analisar a percepção de mulheres sobre o parto e sobre a figura da doula no processo de parturição. Foram entrevistadas nove mulheres, com idades entre 19 a 35 anos, que tiveram uma gestação de baixo risco e que foram acompanhadas por doulas durante a gestação, parto e/ou no período pós-parto. Os relatos foram transcritos na íntegra e emergiram três categorias finais: Práticas Institucionais e Ambiência; Enfrentamento da Dor; e Presença da Doula e Importância da Equipe. Concluiu-se que a doula cumpre um papel importante ao proporcionar confiança e ao utilizar técnicas para o alívio da dor, entretanto, cabe ressaltar que apenas a sua presença não garante o respeito pelos direitos e individualidade das mulheres e um parto humanizado.

The care offered by the doula, a professional who guides and assists the woman during pregnancy, childbirth and postpartum, is considered to be nurturing and tends to foster the emotional wellbeing of the parturient, helping her to cope with possible discomfort. The aim of this research was to analyze how women perceive childbirth and the doula figure in the parturition process. Nine women, aged 19-35 years, who were experiencing low-risk pregnancies and were attended to by doulas during gestation, delivery and / or in the postpartum period, were interviewed. The reports were transcribed in full and three final categories emerged: Institutional Practices and ambience; Coping with Pain; Doula Presence and Team Importance. It was concluded that the doula plays an important role in providing confidence and on in the usage of pain relief, techniques however, it should be emphasized that relying solely on this professional presence does not guarantee the respect for the mother-to-be's rights and individuality and more importantly, humanized childbirth.

Los cuidados ofrecidos por la doula, profesional que orienta y asiste a la mujer durante el embarazo, en el parto y en el posparto, son considerados como acogedores y tienden a promover el bienestar emocional de la gestante, auxiliándola a enfrentar situaciones de incomodidad. El objetivo de esta investigación fue analizar la percepción de mujeres sobre el parto y sobre la figura de la doula en ese proceso. Nueve mujeres fueron entrevistadas, con edades entre 19 y 35 años, las cuales tuvieron un embarazo de bajo riesgo y fueron acompañadas por doulas durante la gestación, parto y / o en el período posparto. Los relatos fueron totalmente transcritos, del cual surgieron tres categorías finales: Prácticas Institucionales y ambientación hospitalaria; Enfrentamiento del dolor; Y Presencia de la Doula e Importancia del Equipo. Se concluyó que la doula cumple un papel importante al proporcionar confianza y al utilizar técnicas para el alivio del dolor, sin embargo, cabe resaltar que sólo su presencia no garantiza el respeto por los derechos e individualidad de las mujeres y un parto humanizado.

Application of Doula delivery combined with delivery ball midwifery in VBAC patients / 中国实用护理杂志

Objective To discuss the application value of Doula delivery combined with delivery ball (vaginal birth after in cesarean, VBAC) in patients. Methods 80 cases of successful VBAC delivery in our hospital are randomly selected from January to September, 2017 as observation group, with patients who are given Doula delivery combined with delivery ball midwifery and continued monitoring of fetal heart rate; Another 80 cases of successful VBAC delivery in our hospital are randomly selected from January to December, 2016 as comparison group, with patients who are given free position delivery and continued monitoring of fetal heart rate. Results The incidence of gradeⅡpain in the two groups was 81.25% (65/80), which was higher than that of the control group (56.25% (45/80) ); The incidence of gradeⅢ pain was 16.25% (13/80), which was lower than that of the control group(37.50% (30/80) ). The difference between the 2 groups was statistically significant (χ2=11.64, 9.19, P<0.01). In the first stage of labor, the observation group was (290.02 ± 181.41) min, and the control group was (510.15 ± 91.22) min, and the 2 groups were statistically significant (t=-9.696, P<0.01). There was no significant difference in the amount of bleeding, neonatal score and neonatal asphyxia rate at the second, third stage of labor (P>0.05). Conclusions Doula delivery combined with birthing midwifery can be used in the delivery of VBAC. It can relieve pain and shorten the first stage of labor, which is worthy of promotion.

Application of PDCA Quality Management Combined with Hospital Quality Control System in Doula Delivery of Primipara / 沈阳医学院学报

Objective:To explore the application effect of PDCA quality management combined with hospital quality control system in Doula delivery of primipara.Methods:Our hospital started to implement the quality management model of PDCA from Jul 2014. According to the different nursing management methods, primipara were divided into treatment group and control group. Primipara in control group from Jan 2013 to Jun 2014 received the traditional nursing mode,primipara in the treatment group from Jul 2014 to Sep 2015 received PDCA quality management combined with hospital quality control system in Doula delivery.Nursing satisfaction, the production process of the status, mode of delivery, postpartum hemorrhage, neonatal outcome were compared between the two groups.Results:In the treatment group,the first,second,third and the total labor time were significantly shorter than that in the control group (P<0??05).The probability of natural childbirth way in the treatment group was significantly higher than that in the control group,postpartum hemorrhage amount was significantly less than that in the control group (P<0??05),the rate of neonatal asphyxia was significantly lower than that in the control group,Apgar score was significantly higher than that in the control group (P<0??05). Nursing satisfaction in the treatment group was higher than that in the control group (P<0??05). Conclusion:The clinical efficacy of PDCA quality management combined with hospital quality control system in Doula delivery of primipara can be effectively improved,can significantly shorten labor time,and improve the neonatal outcome.

Study on the effect of the active phase of Doula delivery ball apparatus combined with correct occipitoposterior / 中国综合临床

Objective To investigate the effect of Doula delivery ball apparatus combined with correct occipitoposterior.Methods Four hundred primiparas whose dilatation of cervix of 3 cm and position of foetus was occipitopostenor position, were randomly divided into observation group and control group according their wishes, and each group of 200 cases.Doula delivery ball was used for the observation group,while the free body position, the traditional delivery mode was the control group.The vaginal delivery rate, degree of pain, postpartum 2 h bleeding volume and neonatal asphyxia rate were compared between the two groups.Results The degree of pain Ⅲ degree was 4.0％ (8/200) ,lower than the control group(50.0％ (100/200), x2 =11.55,P＜0.01).The vaginal delivery rate in observation group was 84.5％ (169/200), higher than that in control group (60.5％ (121/200);x2 =28.905,P=0.001).Postpartum 2H bleeding was (156.3±53.2) ml, lower than the control group((268.1±54.6) ml, t =20.70, P＜0.01).The Postpartum bleeding rate was 0.5％ (1/200), lower than that in control group (4.0％ (8/200) ,P =0.018).Conclusion Doula delivery ball is applied to the first active stage of labor can effectively relieve pain, promote the safety of natural childbirth.

Effect of "one-to-one"full-course Doola accompanied delivery on the ontcome of puerperants / 中国基层医药

Objective To observe the effect of"one-to-one"full-course Doula accompanied delivery on the outcome of puerperants in obstetric departments.Methods Totally 2120 normal full-term puerperants were taken as the observation group.The puerperants in the observation group were accompanied one-to-one for the full course by a maternity nurse who offered services on physiology,psychology and emotion,social adaptative ability,etc.to the puerperants.Totally 2132 normal full-term puerperants were taken as the control group.Results In the observation group,the psychological state was relatively stable,the painful degree Was mild,the incidence rate of postpartum hemorrhage Was low,the rate of uterine-incision delivery Was low,the delivery course was short,the Apgar score of neonates was high,the apnoea is less(P＜0.05),and the satisfactory degree of the puerperants was high.Conclusion The service mode of"one-to-one"full-course Doula accompanied dehvery in obstetric departments is helpful for the health of both mothers and infants,and is good for improving the entire nursing quality and for improving the satisfactory degree.The"one-to-one"full-course Doula accompanied delivery is a good service mode.