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Perineal outcomes in a home birth setting.
- Source :
-
Birth (Berkeley, Calif.) [Birth] 1998 Dec; Vol. 25 (4), pp. 226-34. - Publication Year :
- 1998
-
Abstract
- Background: Perineal lacerations are a source of significant discomfort to many women. This descriptive study examined perineal outcomes in a home birth population, and provides a preliminary description of factors associated with perineal laceration and episiotomy.<br />Methods: Data were drawn from a prospective cohort study of 1404 intended home births in nurse-midwifery practices. Analyses focused on a subgroup of 1068 women in 28 midwifery practices who delivered at home with a midwife in attendance. Perineal trauma included both episiotomy and lacerations. Minor abrasions and superficial lacerations that did not require suturing were included with the intact perineum group. Associations between perineal trauma and study variables were examined in the pooled dataset and for multiparous and nulliparous women separately.<br />Results: In this sample 69.6 percent of the women had an intact perineum, 15 (1.4%) had an episiotomy, 28.9 percent had first- or second-degree lacerations, and 7 women (0.7%) had third- or fourth-degree lacerations. Logistic regression analyses showed that in multiparas, low socioeconomic status and higher parity were associated with intact perineum, whereas older age (>/= 40 yr), previous episiotomy, weight gain of over 40 pounds, prolonged second stage, and the use of oils or lubricants were associated with perineal trauma. Among nulliparas, low socioeconomic status, kneeling or hands-and-knees position at delivery, and manual support of the perineum at delivery were associated with intact perineum, whereas perineal massage during delivery was associated with perineal trauma.<br />Conclusions: The results of this study suggest that it is possible for midwives to achieve a high rate of intact perineums and a low rate of episiotomy in a select setting and with a select population.
- Subjects :
- Adult
Episiotomy statistics & numerical data
Female
Home Childbirth methods
Humans
Logistic Models
Nursing Evaluation Research
Pregnancy
Prospective Studies
Risk Factors
Home Childbirth adverse effects
Home Childbirth nursing
Nurse Midwives
Obstetric Labor Complications etiology
Obstetric Labor Complications nursing
Perineum injuries
Pregnancy Outcome
Subjects
Details
- Language :
- English
- ISSN :
- 0730-7659
- Volume :
- 25
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Birth (Berkeley, Calif.)
- Publication Type :
- Academic Journal
- Accession number :
- 9892890
- Full Text :
- https://doi.org/10.1046/j.1523-536x.1998.00226.x