Labor Down or Bear Down
Autor: | Lisa Hanson, Kathryn Osborne |
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Rok vydání: | 2014 |
Předmět: |
Adult
medicine.medical_specialty Labour economics Time Factors Energy (esotericism) MEDLINE Maternal Welfare Critical Care Nursing Risk Assessment Pediatrics Patient Positioning Scientific evidence Young Adult Labor Stage Second Pregnancy Maternity and Midwifery Pressure medicine Humans Young adult Fetal Monitoring Intensive care medicine Evidence-Based Medicine Labor Obstetric business.industry Infant Newborn Pregnancy Outcome Evidence-based medicine Delivery Obstetric medicine.disease Perinatal Care Female Risk assessment business Cervical Ripening |
Zdroj: | Journal of Perinatal & Neonatal Nursing. 28:117-126 |
ISSN: | 0893-2190 |
DOI: | 10.1097/jpn.0000000000000023 |
Popis: | Scientific evidence supports spontaneous physiologic approaches to second-stage labor care; however, most women in US hospitals continue to receive direction from nurses and birth attendants to use prolonged Valsalva bearing-down efforts as soon as the cervix is completely dilated. Delaying maternal bearing-down efforts during second-stage labor until a woman feels an urge to push (laboring down) results in optimal use of maternal energy, has no detrimental maternal effects, and results in improved fetal oxygenation. Although most commonly used with women who are undergoing epidural anesthesia, laboring down is just one component of physiologic second-stage labor care that can be used to achieve optimal maternal and neonatal outcomes for women with or without an epidural. Prior efforts to translate evidence regarding second-stage labor care to practice have not been successful. In this article, the scientific evidence for second-stage labor care and previous efforts at clinical translation are reviewed. The Ottawa Hospital Second Stage Protocol is presented as a model with potential to allow translation of evidence to practice. Recommendations to enhance widespread adoption of evidence-based practice are provided, including improved collaboration between nurses and birth attendants. |
Databáze: | OpenAIRE |
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