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Updated: Nov 24, 2025

Author Spotlight: Advancing Labor Management Through Electromyometrial Imaging for Understanding Uterine Contractions
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Evidence-based labor management: before labor (Part 1).

Vincenzo Berghella1, Daniele Di Mascio2

  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.

American Journal of Obstetrics & Gynecology MFM
|December 21, 2020
PubMed
Summary
This summary is machine-generated.

Prepare for labor and delivery with evidence-based practices. Recommendations include perineal massage, pelvic floor exercises, and continuous labor support for improved outcomes.

Keywords:
birth assistantdelayed admissiondeliverylaborpelvic floor muscle trainingperineal massageself-diagnosissweeping of membranesx-ray pelvimetry

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • Effective preparation for labor and delivery is crucial for optimizing maternal and neonatal outcomes.
  • Evidence-based guidelines are essential for healthcare providers to offer optimal care during pregnancy and childbirth.

Purpose of the Study:

  • To synthesize high-quality evidence on interventions and care practices for labor and delivery preparation.
  • To provide recommendations for healthcare providers to enhance labor and delivery experiences and outcomes.

Main Methods:

  • Systematic review and synthesis of high-quality evidence regarding interventions for labor and delivery preparation.
  • Inclusion of studies evaluating practices such as perineal massage, pelvic floor exercises, and birth setting choices.

Main Results:

  • High-quality evidence supports perineal massage from 34 weeks gestation and pelvic floor muscle training from 30-32 weeks.
  • Membrane sweeping from 37-38 weeks and continuous labor support by professionals are recommended.
  • For low-risk women, birth center birth and midwife-led care are associated with maternal benefits and higher satisfaction compared to hospital birth.

Conclusions:

  • Implementing recommended preparation strategies, including perineal massage, pelvic floor exercises, and continuous support, can improve labor and delivery outcomes.
  • Tailoring birth settings and care models (e.g., midwife-led care) to risk factors can enhance maternal satisfaction and benefits.
  • Training birth attendants is vital, particularly in low- and middle-income countries, to ensure quality care during labor and delivery.