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Use of manual techniques for perineal support in Norwegian maternity departments
Atle Fretheim1, Tom Tanbo, Siri Vangen
1Norwegian Knowledge Centre for Health Services and Institute of Health and Society, University of Oslo, Norway. atle.fretheim@kunnskapssenteret.no
Background:
The use of supporting techniques to protect the perineum in the last phase of birth is controversial. The objective of this investigation was to gain more knowledge on the use of hand techniques for perineal support in Norwegian maternity wards.
Material And Method:
A questionnaire investigation addressed to the leaders of all the country''s maternity wards.
Results:
We received answers from 39 of 47 maternity wards (83 %) 34 of the wards said that most of those who helped at birth used hand support. 27 wards said that there had been a change in practice, and nearly all of them thought that the changes had taken place during the last five years. 17 wards had written guidelines on the use of hand support techniques. Without exception, use of the hand support technique was recommended. Almost half the wards recommended a modified Ritgen's manoeuvre ("the Finnish manoeuvre") In many wards the choice of perineal support was left to the individual birth helper.
Interpretation:
Supporting techniques now seem to have become standard procedure in the great majority of Norwegian maternity wards. It is therefore difficult to carry out a comparative study between the use of hand manoeuvres and a passive approach. Further investigation should be carried out on whether the introduction of perineal support has had the desired effect.
