The BirthRite Experience
Research Citations

Given the limited space available in the film format, exact wording could not always be preserved. Similar research findings have been summarised together in the text. BirthRite believes it has been faithful to the intent of the authors in its citation, but no valid inference about the quality of the research methods used can be made from the mere fact of such citation. BirthRite encourages viewers to exercise due caution regarding the interpretation and applicability of all medical research.

positioning the woman

A sitting position significantly expands a woman’s pelvic angles and dimensions, allowing the baby to manoeuvre through the pelvis more efficiently.

Michel SC; Rake A; Treiber K, Seifert B; Chaoui R; Huch R; Marincek B; Kubik-Huch RA. MR obstetric pelvimetry: Effect of birthing position on pelvic bony dimensions. AJR Roentgenol. 2002 Oct, 179 (4)?:1063–7

Banack C. The anatomy of pushing. Clarion, vol 16, no 3, December 2002, pp 6–7

finding the correct seating angle

Women’s priorities need to be central to the design of birthing rooms, providing space for labouring in upright positions and assuring privacy and control.

UK National Childbirth Trust, Maternity Care Working Party. Modernising Maternity Care. A Commissioning Toolkit for Primary Care Trusts in England, 2003

coping with pain

Women adopting the upright position in labour experience significantly less pain. The greatest relief occurs in relation to lower back pain.

Gupta JK; Nikodem VC. Cochrane Database, Update Software, issue 2, 2003

Adachi K; Shimada M; Usui A. The relationship between the parturient’s positions and perceptions of labour pain intensity. Nursing Research, vol 52, no 1, Jan/Feb 2003, pp 47–51

Roberts JE. The “push” for evidence: Management of the second stage. Journal of Midwifery and Women’s Health, vol 47, no 1, Jan/Feb 2002, pp 2–15

Albers LL; Anderson D: Craigin L; et al. The relationship of ambulation in labour to operative delivery. Journal of Nurse-Midwifery, vol 42, no 1, Jan/Feb 1997, pp 4–8

De Jong PR; Johanson RB; Baxen P; et al. Randomised trial comparing the upright and supine positions for the second stage of labour. BJOG, vol 104, no 5, May 1997, pp 567–571

Waldenstrom U; Gottvall K. A randomised trial of birthing stool or conventional semi-recumbent position for second stage labour. Birth, March, 18 (1)?:5–10, 1991

Stewart P; Spilby H. A randomised study of the sitting position for delivery using a newly designed obstetric chair. BJOG, 96:327–333, March 1989

Romond JL; Taylor-Baker I. Squatting in childbirth: A new look at an old tradition. JOGGN, October 1985, pp 406–411

putting the woman first

A home-like setting results in increased satisfaction with care and decreased requirement for analgesia, anaesthesia and augmented labour.

Hodnett ED. Home-like vs conventional institutional settings for birth. Cochrane Library. Oxford: Update Software, issue 2, 2003

the nurture of relaxation

The upright position has the distinct advantage of facilitating efficient uterine contractions and a decrease in duration of labour.

Gupta JK; Nikodem VC. Cochrane Database, Update Software, issue 2, 2003

Andrews CM; Chrzanowski M. Maternal position, labor and comfort. Applied Nursing Research, vol 3, no 1, February 1990, pp 7–13

Romond JL; Taylor-Baker I. Squatting in childbirth: A new look at an old tradition. JOGGN, October 1985, pp 406–411

interactive engagement

Continuous support from the midwife during labour reduces the likelihood of medication, operative delivery and a 5-minute Apgar score of less than 7. It is also associated with a higher sense of overall satisfaction and personal control for women.

Hodnett ED. Caregiver support for women during childbirth. The Cochrane Library. Oxford: update Software, issue 2, 2003

Homer CSE; Davis GK; Cooke M. Women’s experiences of continuity of midwifery care in a randomised controlled trial in Australia. Midwifery, vol 18, no 2, June 2002, pp102–112

Hunter LP. Being with woman: A guiding concept for the care of labouring women. JOGNN, vol 31, no 6, Nov/Dec 2002, pp 650–657

Biro MA; Waldenstrom U; Pannifex JH. Team midwifery care in a tertiary level obstetric service: A randomised controlled trial. Birth, vol 27, no 3, September 2000, pp 168–173

caring for the labouring woman

Popular pressure insisting upon less invasive, more natural birth management can be well integrated into the security-oriented way of thinking of classical medicine.

Eberhardt J; Geissbuhler V. Influence of alternative birth methods and traditional birth management. Fetal Diagnosis and Therapy, vol 15, no 5, Sep/Oct 2000, pp 283–290

oedema and perineum

Significant perineal oedema or venous congestion was not observed in the upright group.

Waldenstrom U; Gottvall K. A randomized trial of birthing stool or conventional semi-recumbent position for second stage labour. Birth 18:5–10, 1991

Gardosi J; Sylvester S; B-Lynch C. Alternative positions in the second stage of labour: A randomised control trial. Br J Obstet Gynaecol. Nov; 96 (11)? 1989

Women who adopt the upright posture experience less pain, less perineal trauma and fewer episiotomies than women in supine positions.

Bomfim-Hyppolito S. Influence of the position of the mother at delivery over some maternal and neonatal outcomes. International Journal of Gynecology and Obstetrics, vol 63, suppl 1, December 1998, pp 67–73

De Jong PR; Johanson RB; Baxen P; et al. Randomised trial comparing the upright and supine positions for the second stage of labour. BJOG, vol 104, no 5, May 1997, pp 567–571

Kleine-Tebbe A; David M; Faric M. Upright birthing positions — more birth canal injuries? Zentralblatt Gynaekologie 1996, 118(8)?:448–52

Gardosi J; Sylvester S; B-Lynch C. Alternative positions in the second stage of labour: A randomised control trial. Br J Obstet Gynaecol. Nov; 96 (11)? 1989

pushing re-examined

The considerable physiological and psychological maternal fatigue, induced by long periods of strong pushing in conjunction with sustained breath-holding, needs to be minimised.

Mayberry LJ; Gennaro S; Strange L; et al. Maternal fatigue: Implications of second stage nursing care. JOGNN, vol 28, no 2, March/April 1999

the power of relaxation

The duration of “active pushing” is associated with fetal acidosis, severe variable decelerations, maternal exhaustion and denervation injury to perineal musculature.

Roberts JE. The “push” for evidence: Management of the second stage. Journal of Midwifery and Women’s Health, vol 47, no 1, Jan/Feb 2002, pp 2–15

The overwhelming majority of mothers would request a birthing seat again for a future birth. No mother using the bed said she would opt for the bed in the future.

Smith S. Birth Stools. Midwifery Today, no 39, Autumn 1996, pp 16–18

Stewart P; Spiby H. A randomised study of the sitting position for delivery using a newly designed obstetric chair. BJOG, 96:327–333, March 1989

protecting the perineum

Methods to prevent perineal trauma include avoiding episiotomy and slowing delivery of the head to allow the perineum time to stretch. Routine episiotomy is no longer advisable.

Eason E; Feldman P. Much ado about a little cut: Is episiotomy worthwhile? Obstetrics and Gynecology, vol 95, no 4, April 2000, pp 616–618

Eason E; Labrecque M; Feldman P. Preventing trauma during childbirth: A systematic review. Obstet Gynecol. Mar;95(3)?;464–71, 2000

There were significantly fewer episiotomies, and overall less 2nd-, 3rd- and 4th-degree trauma, in the upright group.

Gupta JK; Nikodem VC. Cochrane Database, Update Software, issue 2, 2003

De Jong PR; Johanson RB; Baxen P; et al. Randomised trial comparing the upright and supine positions for the second stage of labour. BJOG, vol 104, no 5, May 1997, pp 567–571

Olson C; Smith-Cox N. Maternal birthing positions and perineal injury. Journal of Family Practice, vol 30, no 5:553–557, May 1990

Stewart P; Hillan E; Calder Rottenrow A. A randomised trial to evaluate the use of a birth chair for delivery. The Lancet, June 1983, pp 1296–1298

if pushing is really necessary

Moving from recumbent to upright positions was often perceived to be beneficial when there was slow progress. It resulted in a higher rate of intact perineums, improved fetal heart rate patterns and a clinically apparent reduction in forceps deliveries.

Gupta JK; Nikodem VC. Cochrane Database, Update Software, issue 2, 2003

De Jong PR; Johanson RB; Baxen P; et al. Randomised trial comparing the upright and supine positions for the second stage of labour. BJOG, vol 104, no 5, May 1997, pp 567–571

Golay J; Vedam S; Sorger L. The squatting position for the second stage of labour: Effects on labour and maternal and fetal wellbeing. Birth, 20:2, pp 73–78, June 1993

Crowley P; Elbourne D; Ashurst J; Garcia J; Murphy D; Duignan N. Delivery in an obstetric chair: A randomised controlled trial. British Journal of Obstetrics and Gynaecology 98: 667–674, July 1991

Gardosi J; Sylvester S; B-Lynch C. Alternative positions in the second stage of labour:

A randomised control trial. Br J Obstet Gynaecol. Nov; 96 (11)? 1989

engaging the parents

If women are to be empowered by making choices for childbirth and feeling “in control”, then it is important for midwives to explore and discover their wishes and feelings so that realistic expectations can be promoted and then hopefully fulfilled.

Gibbins J; Thomson AM. Women’s expectations and experiences of childbirth. Midwifery, vol 17, no 4, December 2001, pp 302–33

bonding with the baby

More women in the upright group described their births as “very happy”.

De Jong PR; Johanson RB; Baxen P; et al. Randomised trial comparing the upright and supine positions for the second stage of labour. BJOG, vol 104, no 5, May 1997, pp 567–571

birthing the placenta

Postnatal haemoglobin data and transfusion rates do not sustain the claim of higher blood loss amongst women giving birth upright.

De Jong PR; Johanson RB; Baxen P; et al. Randomised trial comparing the upright and supine positions for the second stage of labour. BJOG, vol 104, no 5, May 1997, pp 567–571

Gardosi J; Sylvester S; B-Lynch C. Alternative positions in the second stage of labour: A randomised control trial. Br J Obstet Gynaecol. Nov; 96 (11)? 1989

large babies

The all-fours manoeuvre appears to be a rapid, safe and effective technique for reducing shoulder dystocia in labouring women.

Bruner JP; Drummond SB; Meenan AL; and others. All-fours manoeuvre for reducing shoulder dystocia during labour. Journal of Reproductive Medicine, vol 43, no 5, May 1998, pp 439–443

assisted vaginal births

The supine position is associated with a prolonged 2nd stage of labour and persistence of occipito-posterior presentations. The sitting position offers the advantages of the gravitation effect and allows superior patient participation.

Kelly FW; Terry R; Naglieri R. A review of alternative birthing positions. J Am Osteopath Association, Sep, 99(9)?:470–4, 1999

breech

Practitioners should maintain skills in vaginal breech delivery for women not wishing or not able to be delivered by caesarean section, or who present with an undiagnosed breech in advanced labour.

Tunde-Byass MO; Hannah ME. Breech vaginal delivery at or near term. Seminars in Perinatology, vol 27, no 1, February 2002, pp34–45

Giluiani A; Scholl WMJ; Basver A; et al. Mode of delivery and outcome of 699 term singleton breech deliveries at a single center. American Journal of Obstetrics and Gynecology, vol 187, no 6, December 2002, pp 1694–1698

Helewa ME. 2000: Year of the breech. Journal SOGC, vol 23, no 4, April 2001, pp 313–318

Johanson R. Breech birth: Current obstetric thinking. MIDIRS Midwifery Digest, vol 11, no 3, suppl 2, September 2001, pp 26–29



http://www.birthrite.com.au/eng/products/films/the_birthrite_experience/citations.htm
Last altered: 2013-06-07 [ISO 8601] Copyright © 2006–2013 BirthRite. All rights reserved.