Antenatal education incorporating complementary medicine techniques for labour and birth to reduce the rates of epidural in primiparous women: A randomised control trial.

Autor: Fleet JA; UniSA Clinical & Health Sciences, University of South Australia, City East Campus, Centenary Building, North Terrace, Adelaide, SA 5000, Australia; Rosemary Bryant AO Research Centre, University of South Australia, Australia. Electronic address: Julie.fleet@unisa.edu.au., Adelson P; Rosemary Bryant AO Research Centre, University of South Australia, Australia., McKellar L; Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, Australian Catholic University (Mel), Australia. Electronic address: https://twitter.com/DrLoisMcKellar1., Steen M; Bentley Campus and Department of Nursing and Midwifery Education and Research (DNAMER), Faculty of Health Sciences, King Edward Memorial Hospital, Curtin University, Perth, WA, Australia. Electronic address: https://twitter.com/ProfMarySteen.
Jazyk: angličtina
Zdroj: Midwifery [Midwifery] 2024 Dec; Vol. 139, pp. 104170. Date of Electronic Publication: 2024 Aug 30.
DOI: 10.1016/j.midw.2024.104170
Abstrakt: Problem: Globally medical management of labour and birth has significantly increased, with epidurals attributed to the cascade of interventions.
Background: There are few randomised control trials that evaluate the effectiveness of antenatal education programs. A previous trial at two Australian hospitals found an antenatal program of integrative complementary therapies significantly reduced rates of interventions for low-risk primiparous women.
Aim: To reduce rates of intervention in labour and birth, with a primary outcome of decreased epidural use during labour.
Methods: Low to moderate risk primiparous women were randomised at 24-36 weeks' gestation to the intervention group and standard care, or standard care alone. Clinical and psychological measures were analysed by intention-to-treat. Trial registration ACTRN12618001353280 FINDINGS: In total, 178 women participated (n = 88 intervention, n = 90 Standard care), demographic characteristics were similar between groups, almost half (49 %) reported a pre-existing medical condition, and wellbeing scores fell within the average range. Epidural use was lower in the intervention group (47.7% vs 56.7 %) with higher rates of vaginal birth (52.3% vs 42.2 %), however, no statistical differences for birth outcomes were found between groups. Attitude to childbirth scores were statistically higher for women who attended the intervention (59.1 vs 54.3 p00.001).
Discussion: Higher psychometric scores demonstrated women in the intervention group felt an increased sense of coping and control. Antenatal education that includes complementary therapies can reduce fear and improve attitudes about childbirth.
Conclusions: Replicating study protocols enabled the generalisability of findings to a more diverse group of women, and data will contribute to a larger meta-analysis design to detect smaller treatment effects for operative birth.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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