A critical review of labor and birth care

Citation metadata

From: Journal of Family Practice(Vol. 33, Issue 3)
Publisher: Jobson Medical Information LLC
Document Type: Article
Length: 9,889 words

Document controls

Main content

Abstract :

A critical review is presented by the Obstetrical Interest Group of the North American Primary Care Research Group on labor and birth care. With emphasis on low-risk labors and births, a literature review was conducted using computer searches, literature exchanges, and personal communications of the members of this group. The aspects covered stressed a family-centered birth care approach, which has been sought by many care providers, professional associations, and maternity sections of hospitals. Several key areas are discussed, and recommendations and conclusions on various care practices are outlined. These areas include family involvement, comfort measures (for the woman in labor), intrapartum fetal monitoring, labor augmentation, birth positions, and episiotomies. Practices and methods within these seven categories are ranked based on the amount of supportive evidence that was found in the literature, data from clinical trials, and general clinical experience. Some general conclusions are discussed. Women should be provided with continuous support throughout labor; the presence of the father has been found to increase the woman's satisfaction of the birth process. Thus far, there is no conclusive evidence regarding the impact upon siblings who witness their mother's labor. Comfort measures discussed include previous training in positive imagery and relaxation techniques, along with prenatal education. Also discussed are pharmaceutical interventions, their risks, and benefits; some commonly used drug treatments for pain relief are nitrous oxide, Demerol, epidural anesthesia, and paracervical anesthesia. No evidence for improved perinatal outcome was associated with the use of electronic fetal monitoring, although this technique is commonly used. Some methods used for inducing labor or speeding a prolonged labor include oxytocin, breast stimulation, and amniotomy (surgical rupture of the fetal membranes). Birth positions and episiotomies are also reviewed. In general, uncomplicated vaginal delivery does not require routine episiotomy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Source Citation

Source Citation   

Gale Document Number: GALE|A11393077