1A. Consider all options—home, birth center, or hospital—recognizing that birth experiences are enhanced in settings that support parents’ informed choices for the labor, birthing, and postpartum process.
Birth experiences are enhanced by:
References:
Abstract 1:
Premise: Whirlpool use for women in labor is not currently common, but represents a significant benefit in terms of increase in relaxation and/or decrease in need for analgesia.
Research Questions: To what significance can the use of the whirlpool during labor decrease the requirements of fewer pharmacological agents and what is its overall effect on birthing outcomes?
Background: The evaluation of the use of whirlpools in childbirth and its effect on the use of narcotic and epidural requirements.
Subjects: A total of 393 laboring women were assigned to the experimental group and provided use of the whirlpool, while 392 were assigned to the control group and provided with conventional care without whirlpool use.
Study Design: A randomized, controlled trial.
Findings: The group of women using whirlpool bathing during labor demonstrated a statistically significant decrease in the need for analgesia during labor. The experimental group experienced fewer deliveries by use of forceps and vacuum. No differences were noted in the rates of maternal and newborn infection. Labor for primiparous women was longer with whirlpool tub use. The mothers in the experimental group expressed overall satisfaction with the use of the whirlpool in combination with the added nursing support.
Research reviewed by Barbara Accord, RN, while a student at Virginia Commonwealth University School of Nursing, in Richmond, VA.
Abstract 2:
Premise: Baroque music, new age music, and ocean sounds during labor can increase relaxation and lower the level of pain.
Research Question: Does listening to music and ocean sounds during labor increase the level of relaxation during labor for Lamaze-trained women?
Background: The potential advantages of using music and ocean sounds during labor include reduction of anxiety and increased levels of relaxation.
Subjects: The participants came from a convenience sample of 36 Lamaze-trained women.
Study Design: Relaxation levels were monitored by means of a biofeedback instrument. The instrument measured two electromyographic sites, skin conductance level, and skin temperature. The types of music/sound used during the research include baroque music, new age music, and ocean sounds. A soothing and comfortable environment was established prior to initiation of music/sounds.
Findings: Each type of music/sound tape used had the same size effect, leading to increased relaxation. This was evidenced by measurement of all four biofeedback results.
Research reviewed by Marjorie Lampman, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.
Abstract 3:
Premise: Aromatherapy relieves emotional, physical, and environmental distress on some women in labor.
Research Question: Is aromatherapy a useful practice for women in labor?
Background: The potential benefits of complimentary therapy for laboring women are anxiety reduction, sense of control, and an improved atmosphere and relationship with caregivers. Research is needed to guide these practices in order to safely incorporate complimentary therapies.
Subjects: A total of 585 women in labor participated in the pilot study, which started in June 1990 and lasted six months.
Study Design: Midwives trained in aromatherapy used essential oils with the participants and documented the effects of each oil. The mothers completed evaluations following the birth and prior to the transfer from the delivery room.
Findings: A total of 366 women (62%) described the essential oil(s) they used as "effective," 67 (12%) found that using essential oils was "not effective," 101 women (17%) could not make a decision, and 51 women (9%) did not record a decision, although 14 of these participants made comments that were all positive. Sixteen women (3%) described transient, unwanted effects. The majority of women in labor found aromatherapy to be beneficial.
Research reviewed by Marjorie Lampman, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.
Abstract 4:
Premise: Women who perceive they have control over what happens to them during labor have a higher level of satisfaction with pain relief during labor.
Research Question: Is there a positive relationship between pain relief during labor and a woman’s sense of control during labor?
Background: Women in labor may have a high level of pain. The woman’s perception of her ability to deal with this pain is viewed as pain relief. Even though complete pain relief might not be achieved, satisfaction of pain relief may exist. The woman’s degree of control greatly affects the perceived satisfaction of pain relief.
Subjects: One hundred Caucasian women (50 primagravidae and 50 multigravidae) who had vaginal deliveries and were patients in a teaching hospital in Northern Ireland.
Study Design: A questionnaire was developed that included visual analogue scales to measure the management of labor pain. Levels of satisfaction were measured using a Likert scale. Level of personal control was measured by using a modified version of Slade, et al’s (1993) personal control scale. A demographic component also existed. The women were asked to complete the questionnaire within 48 hours of birth.
Findings: The demographic profile revealed the mean age of primagravidae was 25.6 years and the multigravidae mean was 29.5 years. Most of the women were satisfied with pain relief. Many factors affect personal control including the relationship between the caregiver and the patient, use of coping strategies, and relaxation techniques. The study concluded that many factors influence an individual’s feelings of personal control and pain relief.
Research reviewed by Marjorie Lampman, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.