Abstract
Aim
To determine the effects of protocol of admitting women in active labour on childbirth
method and interventions during labour and childbirth.
Methods
This single-blind randomised clinical trial was conducted in a public hospital in
Mazandaran province (Iran) in 2017. Two hundred nulliparous low-risk women were randomly
assigned into intervention and control groups. The participant women were admitted
in the intervention group using the admission protocol and to the group control by
staff midwives and doctors. The admission criteria of the protocol were: the presence
of regular, painful contractions, the cervix at least four cm dilated and at least
one of the following cues: cervix effaced, and spontaneous rupture of membranes, or
“show”. The primary outcome measure was childbirth method. Data were analyzed in SPSS-22
using Mann–Whitney and Chi–square tests. The level of statistical significance was
set as p < 0.05.
Finding
There were significant differences between the intervention and control groups in
the number of caesarian section (CS) (p < 0.001). Two groups had a statistically significant difference in amniotomy (p = 0.003), augmentation by oxytocin (p < 0.001), number of vaginal examinations (p < 0.001) and fundal pressure (p < 0.001).
Conclusions
Using a protocol for admission of low risk nulliparous women in active labour contributed
to reduction of the primary caesarean section rate and interventions during childbirth.
A risk assessment and using evidence informed guidelines in admission can contribute
to reduce unsafe and harmful practices and support normalisation of birth. This is
essential for demedicalisation and a useful strategy for reducing primary CS.
Abbreviations:
BMI (Body Mass Index), CS (Caesarean Sections), FHR (Fetal Heart Rate), WHO (World Health Organisation)Keywords
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Article info
Publication history
Published online: December 28, 2019
Accepted:
December 9,
2019
Received in revised form:
December 7,
2019
Received:
August 24,
2019
Identification
Copyright
© 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
