Sentences with phrase «labour and birth care»

Labour and birth care for women with high BGLs should centre on minimising the chance of shoulder dystocia, and supporting the baby to regulate their own BGLs after birth.

Not exact matches

If you have been hurt badly, lied to or had significant physical and emotional damage from traditional medical care — being forced back into that environment will cause fear, that will hamper labour due to how women were made (any threat the woman feels causes labour to slow until she no longer experiences that «fight or flight response», and when she feels safe again, labour should resume)-- labour slows and then interventions «have» to be done... and the cycle repeats itself — reenforcing the belief that the hospital is not the place to birth.

Low risk women in primary care at the onset of labour with planned home birth had lower rates of severe acute maternal morbidity, postpartum haemorrhage, and manual removal of placenta than those with planned hospital birth.

He has published guidelines on vaginal breech birth and papers on the negative effect of epidural analgesia on labour, two - step delivery and the over-diagnosis of shoulder dystocia, the limitations of randomized trials for evaluating complex phenomena, the pitfalls of guideline - based care, and the ethics of re-infibulation.

Her other interests include: - The safety of homebirth and other low - technology models of care - Third stage of labour, cord clamping and lotus birth - Sexuality and childbirth - Ultrasound and prenatal testing for Down syndrome - Early parenting practices including bed sharing and breastfeeding

Dr. Shah's article stems from the United Kingdom's National Institute for Health and Care Excellence (NICE) new set of guidelines, published in December 2014, which offer evidence - based advice for the care of pregnant women and babies during labour and immediately after biCare Excellence (NICE) new set of guidelines, published in December 2014, which offer evidence - based advice for the care of pregnant women and babies during labour and immediately after bicare of pregnant women and babies during labour and immediately after birth.

There are many benefits of going to antenatal classes; they are a great way to learn about pregnancy, labour, birth and caring for a newborn baby and you have access to trained professionals to ask any questions you might have and share any concerns.

Our classes cover all the basic information about labour and birth, but also include strategies for pain management, choices, decision - making during labour, coping techniques, and medical options, as well as breast feeding, baby care, and postpartum reality.

At John and Lizzie's the care is based on Active Birth principles: the idea that women have faster, safer, easier deliveries (and their babies a better birth experience) when they move about in labour and give birth standing or squatting, rather than lying on their bBirth principles: the idea that women have faster, safer, easier deliveries (and their babies a better birth experience) when they move about in labour and give birth standing or squatting, rather than lying on their bbirth experience) when they move about in labour and give birth standing or squatting, rather than lying on their bbirth standing or squatting, rather than lying on their backs.

Twelve critical success factors, including «the right attitude, focus, leadership, teamwork, support, and a personal and financial commitment to best practice and continuous quality improvement,» were identified, based on practices at four Ontario hospitals with comparatively low caesarean rates.19 The «right attitude» included taking pride in a low caesarean rate, developing a culture of birth as a normal physiological process, and having a commitment to one to one supportive care during active labour.

What is not yet clear is the relative contribution to birth outcomes of health professionals» attitudes, continuity of carer, midwife managed or community based care, and implementation of specific practices (such as continuous emotional and physical support throughout labour, use of immersion in water to ease labour pain, encouraging women to remain upright and mobile, minimising use of epidural analgesia, and home visits to diagnose labour before admission to birth centre or hospital).

Conclusions: Low risk women in primary care at the onset of labour with planned home birth had lower rates of severe acute maternal morbidity, postpartum haemorrhage, and manual removal of placenta than those with planned hospital birth.

The 100 question survey examined women's experiences from their perspectives on a variety of issues relating to care options in Irish maternity services, ante-natal care, labour and birth, and postnatal care.

Objective To compare perinatal outcomes, maternal outcomes, and interventions in labour by planned place of birth at the start of care in labour for women with low risk pregnancies.

Main outcome measure A composite primary outcome of perinatal mortality and intrapartum related neonatal morbidities (stillbirth after start of care in labour, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, or fractured clavicle) was used to compare outcomes by planned place of birth at the start of care in labour (at home, freestanding midwifery units, alongside midwifery units, and obstetric units).

For this reason, birth practices, care, and treatments in pregnancy, labour, and birth should reflect the protection of the health of mothers and babies.

There was no difference overall between birth settings in the incidence of the primary outcome (composite of perinatal mortality and intrapartum related neonatal morbidities), but there was a significant excess of the primary outcome in births planned at home compared with those planned in obstetric units in the restricted group of women without complicating conditions at the start of care in labour.

The primary outcome was a composite of perinatal mortality and specific neonatal morbidities: stillbirth after the start of care in labour, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, and fractured clavicle.13 This composite measure was designed to capture outcomes that may be related to the quality of intrapartum care, including morbidities associated with intrapartum asphyxia and birth trauma.

Instead, a way of measuring care is to look at the rates of complications that arise in pregnancy, and during labour, birth, and the postpartum period.

The strengths of the study include the ability to compare outcomes by the woman's planned place of birth at the start of care in labour, the high participation of midwifery units and trusts in England, the large sample size and statistical power to detect clinically important differences in adverse perinatal outcomes, the minimisation of selection bias through achievement of a high response rate and absence of self selection bias due to non-consent, the ability to compare groups that were similar in terms of identified clinical risk (according to current clinical guidelines) and to further increase the comparability of the groups by conducting an additional analysis restricted to women with no complicating conditions identified at the start of care in labour, and the ability to control for several important potential confounders.

Our analysis focused on personal details of the clients, reasons for leaving care prenatally, the rates and reasons for transfer to hospital during labour and post partum, medical interventions, health and admission to hospital of the newborn or mother from birth up to six weeks post partum, intrapartum and neonatal mortality, and breast feeding.

Induction of Labour: * higher rates of Caesarean Section * increased risk of your baby being admitted to NICU (neonatal intensive care unit) * increased risk of forceps or vacuum (assisted delivery) * contractions may be stronger than a spontaneous labour * your labour is no longer considered «low risk» — less choices in where and how you birth, restricted birth positions, continuous monitoring CTG, time limits for which to laboLabour: * higher rates of Caesarean Section * increased risk of your baby being admitted to NICU (neonatal intensive care unit) * increased risk of forceps or vacuum (assisted delivery) * contractions may be stronger than a spontaneous labour * your labour is no longer considered «low risk» — less choices in where and how you birth, restricted birth positions, continuous monitoring CTG, time limits for which to labolabour * your labour is no longer considered «low risk» — less choices in where and how you birth, restricted birth positions, continuous monitoring CTG, time limits for which to labolabour is no longer considered «low risk» — less choices in where and how you birth, restricted birth positions, continuous monitoring CTG, time limits for which to labourlabour in.

The figure provides an overview of why women left care before labour and their intended place of birth at the start of labour.

The hospital midwives will care for you during labour and birth and, in most cases, you may not need to see a doctor at all.

Maternal health / maternity services covers a wide spectrum of care and care options — from fertility, reproductive health, pregnancy, labour, birth, postpartum and beyond — some queries extending into physical complaints as the result of childbirth decades following the birth experience.

«The continuity of the care I offer throughout pregnancy, knowing that I will be there for a family during pregnancy, the labour the birth and afterwards when they are adjusting to motherhood is one of the factors that contribute to the safety of home birth.

Planned birth at home in low risk women without complicating conditions at the start of care in labour was associated with significant cost savings and a significant decrease in adverse perinatal outcomes avoided.

Unit cost estimation involved a combination of bottom - up and top - down costing methods and followed guidance on costing healthcare services as part of an economic evaluation.15 17 Detailed unit costs, derived from the finance departments of participating trusts and information provided by senior midwives, were estimated for resource inputs into the following components of intrapartum and after birth care for all settings: homebirth delivery packs; NHS reimbursement for midwifery travel; some forms of pain relief; alternative modes of delivery; active management of the third stage of labour; suturing for episiotomy; suturing third and fourth degree perineal tears; manual removal of the placenta; blood transfusions; and care after a stillbirth or neonatal death.

Secondly, the limited time horizon of the study meant that the follow - up of outcomes for both mother and baby did not extend beyond the time period of labour and care immediately after birth, or higher level postnatal or neonatal care when this was received.

Estimates of the numbers of women booked for home birth but delivering in hospital were even more difficult to obtain because hospital records do not always specify this information accurately and no national estimate exists.1 4 Data collected in this region in 1983 suggested that 35 % of these women changed to hospital based care either before or during labour, and a more detailed prospective study of all planned home births in 1993 found a total transfer rate of 43 %.8 Women were classified as having booked for a home birth when a community midwife had accepted a woman for home delivery and had this arrangement accepted by her manager and supervisor of midwives at any stage in pregnancy, irrespective of any later change of plan.

Midwives in BC offer primary care to healthy pregnant women and their normal newborn babies from early pregnancy, through labour and birth, and up to three months postpartum.

These forms were designed to capture the pathways of care experienced by individual women progressing through the stages of labour and care after birth and their associated resource inputs.

Perinatal loss to the 64 women who booked for hospital delivery but delivered outside and to the 67 women who delivered outside hospital without ever making arrangements to receive professional care during labour accounted for the high perinatal mortality (134 deaths in 3466 deliveries) among all births outside hospital.

For low risk women without complicating conditions at the start of care in labour, the mean incremental cost effectiveness ratios associated with switches from planned birth in obstetric unit to non-obstetric unit settings fell in the south west quadrant of the cost effectiveness plane (representing, on average, reduced costs and worse outcomes).25 The mean incremental cost effectiveness ratios ranged from # 143382 (alongside midwifery units) to # 497595 (home)(table 4 ⇓).

In this study of the cost effectiveness of alternative planned places of birth in England in women at low risk of complications before the onset of labour, we found that the cost of intrapartum and after birth care, and associated related complications, was less for births planned at home, in a free standing midwifery unit, or in an alongside midwifery unit compared with planned births in an obstetric unit.

Restriction of the analyses to low risk women without complicating conditions at the start of care in labour narrowed the cost differences between planned places of birth: total mean costs were # 1511 for an obstetric unit, # 1426 for an alongside midwifery unit, # 1405 for a free standing midwifery unit, and for # 1027 the home (table 2 ⇓).

Profiles of resource use, and their associated unit costs, for each planned place of birth are reported in detail in appendices 1 and 2 on bmj.com.25 The total mean costs per low risk woman planning birth in the various settings at the start of care in labour were # 1631 ($ 1950, $ 2603) for an obstetric unit, # 1461 ($ 1747, $ 2332) for an alongside midwifery unit, # 1435 ($ 1715, $ 2290) for a free standing midwifery unit, and # 1067 ($ 1274, $ 1701) for the home (table 1 ⇓).

The guidelines include interventions provided to the mother — for example steroid injections before birth, antibiotics when her water breaks before the onset of labour, and magnesium sulfate to prevent future neurological impairment of the child, as well as interventions for the newborn baby — for example thermal care, feeding support, (e.g. kangaroo mother care, when babies are stable), safe oxygen use, and other treatments to help babies breathe more easily.

A midwife cares for the woman during labour and birth referring to a doctor if there are any deviations from the norm or in the case of an emergency.

Comparison: standard care, which involved shared antenatal care from a GP and hospital midwives, labour and birth and postnatal hospital care from hospital midwives.

Overall, they conclude: «Low risk women in primary care with planned home birth at the onset of labour had a lower rate of severe acute maternal morbidity, postpartum haemorrhage, and manual removal of placenta than those with planned hospital birth.

The midwife - led continuity model of care includes: continuity of care; monitoring the physical, psychological, spiritual and social well being of the woman and family throughout the childbearing cycle; providing the woman with individualised education, counselling and antenatal care; attendance during labour, birth and the immediate postpartum period by a known midwife; ongoing support during the postnatal period; minimising unnecessary technological interventions; and identifying, referring and co-ordinating care for women who require obstetric or other specialist attention.

Midwives use a range of midwifery skills and midwifery interventions across the course of care to «nudge» the pathway of pregnancy, labour and birth to the normal.

The midwife is recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife's own responsibility and to provide care for the newborn and the infant.

The review found that midwife - led care compared to other models of care reduces: preterm births (before 37 weeks) and overall fetal loss and neonatal death before 24 weeks (high - certainty evidence); the use of regional analgesia (epidural / spinal) during labour (high - certainty evidence); and instrumental vaginal births (high - certainty evidence).

Women who had midwife - led continuity models of care were more likely to experience no intrapartum analgesia / anaesthesia (average RR 1.21, 95 % CI 1.06 to 1.37; participants = 10,499; studies = seven), have a longer mean length of labour (hours)(mean difference (MD) 0.50, 95 % CI 0.27 to 0.74; participants = 3328; studies = three) and more likely to be attended at birth by a known midwife (average RR 7.04, 95 % CI 4.48 to 11.08; participants = 6917; studies = seven).

An understanding by health professionals that, rather than concentrate on either «medicalised» or «natural» birth, focussing on individualising care and normalising each woman's experience will ultimately provide the high quality care that labouring women require.

In all standard - care options, women were cared for by whichever midwives and doctors were rostered for duty when they came into the hospital for labour, birth and postnatal care.

Using data from a national study into maternal morbidity and national birth registry data from 1 August 2004 to 1 August 2006, they identified over 146,000 low risk women in primary care at the onset of labour.

Women's experiences of care reported in the original studies include maternal satisfaction with information, advice, explanation, venue of delivery and preparation for labour and birth, as well as perceptions of choice for pain relief and evaluations of carers behaviour.