The second stage of labour

The second stage of labor begins with full dilatation of cervix and ends with delivery of the fetus. In most of the cases the labor progresses uneventfully, without any need of an active intervention but in few cases complications may occur.  With passage of time there has been better understanding about second stage of labor, still there are several grey areas yet to be resolved. This review endeavours to scrutinize a variety of care practices including positions, time and type of pushing, use of epidural analgesia, and perineal support techniques etc and discuss evidence based management of second stage of labor. The review was carried out in the period of 1900-2019 by searching in Pub Med, Embase, Scopus, Google scholar, Web of sciences using relevant key words. Reports, articles, fact sheets and official publications of World health Organization (WHO), Ministry of health and family welfare-Govt of India and various other countries were also reviewed.

Understanding the lived experience of Filipino mothers on water birth

@#<p style="text-align: justify;"><strong>PURPOSE:</strong> The study purported to explore the lived experience of a select group of Filipino mothers who had undergone water birth delivery.</p><p style="text-align: justify;"><strong>DESIGN:</strong> A qualitative, descriptive phenomenology research design was used to investigate the phenomenon. The sample (N=10) was comprised of women who had undergone water birth, 25-45 years old, primiparous and multiparous. A self-report method using face-to-face, in depth, semi structured interviews guided by an aide memoire abetted the data collection procedure. The principles of beneficence, respect for human dignity, and justice were observed throughout the research process.</p><p style="text-align: justify;"><strong>MODE OF ANALYSIS:</strong> Significant statements were culled from the field text and analyzed using Colaizzi method. The validation techniques of members checking and critical friends were utilized.</p><p style="text-align: justify;"><strong>FINDINGS:</strong> The findings revealed that mothers found the experience extraordinary and the warmth and buoyancy of the water used in such mode foster comfort and ease of delivery while enabling them to manage their pains positively. Four themes emerged namely: (1) In her own private world; (2) At her fullest power; (3) To her ease and comfort; and (4) At her own course.</p><p style="text-align: justify;"><strong>CONCLUSIONS:</strong> Research in recent times has provided limited evidence in making water birth a prevalent alternative for women to welcome their babies into this world. It is vital to focus on the experience of water birth from the mother's lens. Water birth has potential benefits to both mother and neonate and promotes maternal satisfaction; however, it remains the responsibility of health practitioners to provide credible evidence of its safety to prove that water birth is a valuable option to conventional delivery.</p>

Trauma perineal: parto acuático versus parto convencional en Centro Hospitalario Nuevo Sanatorio Durango en la Ciudad de México / Perineal trauma: water birth versus conventional vaginal deliveries in Hospital Center Nuevo Sanatorio Durango in Mexico City

Resumen Introducción La atención de parto acuático ha incrementado en popularidad en la Ciudad de México. El Centro Hospitalario Nuevo Sanatorio Durango ha sido pionero en ofrecer la atención de parto bajo el agua. Hasta la fecha, no se han realizado estudios sobre la conducta de los partos acuáticos en México. Objetivo Este estudio intenta evaluar si el parto bajo el agua está asociado a mayor incremento en las tasas de trauma perineal comparándolo con un grupo control de pacientes atendidas por parto convencional. Material y métodos Archivos clínicos de mujeres que se atendieron de parto acuático en el Centro Hospitalario Sanatorio Durango en la Ciudad de México en el periodo comprendido entre 2016 y 2017, revisados retrospectivamente. Los resultados de interés fueron estimar el trauma perineal (desgarros de tercer y cuarto grado) comparándolo con un grupo control de parto convencional. Resultados Se registraron 120 pacientes que se atendieron de parto acuático. Hubo diferencia significativa en los resultados en trauma perineal en el grupo de parto acuático: mayores tasas de periné intacto en mujeres atendidas bajo el agua, por lo que se propone que el parto acuático es protector del trauma perineal. Conclusiones El parto en agua en nuestro centro no parece estar asociado a incremento en los resultados adversos maternos (trauma perineal). Los resultados de este estudio establecen que el parto acuático es una alternativa aceptable para el nacimiento en mujeres de bajo riesgo obstétrico, siempre y cuando cuente con adecuada vigilancia y profesional capacitado.

Abstract Introduction Waterbirth has been increasing in popularity in Mexico City. Hospital Center Nuevo Sanatorio Durango in Mexico City is the pioneer hospital offering water births to women. To date, no studies have been done on the conduct of waterbirths in Mexico. Objective This study aims to evaluate if water immersion during delivery is associated with increased rates of perineal trauma as compared with conventional vaginal deliveries. Material and methods Clinical records of women who birthed underwater at Hospital Center Sanatorio Durango in Mexico City between 2016 and 2017 were retrospectively reviewed. The outcomes of interest were estimated perineal trauma, third or fourth degree. Outcomes were compared against a matched control group of women who had conventional vaginal deliveries. Results Records of 120 women who birthed underwater were accrued. There was a significant difference in maternal outcomes in perineal trauma in water birth: higher rates of intact perineums in women who birth underwater, proposing that water birth is protective against perineal trauma. Conclusions Water birth at our center does not appear to be associated with an increased incidence of adverse maternal outcomes (perineal trauma). The results of this study supported water birth as a birthing option for groups of low-risk women in an obstetrician led setting with good midwifery support.

A case of water birth / 대한산부인과학회잡지

Recently, water birth - labor and/or delivery under warm water - is acceptable and natural to many foreign countries as a method of gentle birth. Although some limitations after water birth were reported, a recent international conference explored many of the issuses and indicated the potential scale and the advantages for its inclusion among the options for labor and delivery under water. We experienced a case of water birth who underwent labor and delivery under water. She delivered normal healthy female baby without conventional episiotomy. No obstetrical ans fetal complications were observed during entire procedure of water birth. So, we report this case with brief review of the literatures.