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Comparison of labour and birth outcomes between nulliparous women who used epidural analgesia in labour and those who did not: A prospective cohort study.

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Intervention or interference? The need for expectant care throughout normal labour.

Cecily M Begley1

  • 1School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.

Sexual & Reproductive Healthcare : Official Journal of the Swedish Association of Midwives
|December 1, 2014
PubMed
Summary

Routine medical interventions during labor, like induction and episiotomy, offer benefits but carry risks. These procedures should be used based on clinical need, not routinely, to avoid harm to mothers and babies.

Keywords:
Active management of the third stageEarly cord clampingEpisiotomyInduction of labourMedico-technical interventionNormal labour

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Evidence-Based Practice

Background:

  • Medico-technical interventions in labor are increasing globally.
  • These interventions have both positive and negative consequences.
  • Interventions must be evidence-based and outweigh potential harm.

Purpose of the Study:

  • To review the effects of three common medico-technical interventions in normal pregnancy and labor.
  • To describe the impacts on both women and neonates.

Main Methods:

  • A comprehensive literature review was conducted.
  • Evidence on benefits and adverse effects of induction of labor, episiotomy, and active management of the third stage of labor was analyzed.

Main Results:

  • All three interventions (induction, episiotomy, active management of third stage) have benefits but also risks.
  • Overuse can cause maternal and neonatal distress, pain, and morbidity.
  • Routine use is not recommended; interventions should be based on clinical need.

Conclusions:

  • Further research is needed on alternative labor induction methods and perineal preservation.
  • Trials comparing expectant and active management of the third stage for low-risk women are recommended.
  • Clinicians should reduce unnecessary reliance on these interventions and enhance skills in alternatives.