SARA BORRELLI Sara.Borrelli@nottingham.ac.uk
Associate Professor
Early pushing urge in labour and midwifery practice: A prospective observational study at an Italian maternity hospital
Borrelli, Sara E.; Locatelli, Anna; Nespoli, Antonella
Authors
Anna Locatelli
Antonella Nespoli
Abstract
OBJECTIVE: to investigate the early pushing urge (EPU) incidence in one maternity unit and explore how it is managed by midwives. The relation to some obstetric outcomes was also observed but not analysed in depth.
DESIGN: prospective observational study.
SETTING: Italian maternity hospital.
SAMPLE: 60 women (44 nullips and 16 multips) experiencing EPU during labour.
FINDINGS: the total EPU incidence percentage was 7.6%. The single midwives’ incidences range had a very wide margin, noting an inverse proportion between the number of diagnoses of EPU and midwife’s waiting time between urge to push and vaginal examination. Two care policies were adopted in relation to the phenomenon: the stop pushing technique (n¼52/60) and the ‘let the woman do what she feels’ technique (n¼8/60). In case of stop pushing techniques, midwives proposed several combined techniques (change of maternal position, blowing breath, vocalisation, use of the bath). The EPU diagnosis at less than 8 cm of cervical dilatation was associated with more medical interventions. Maternal and neonatal outcomes were within the range of normal physiology. An association between the dilatation at EPU diagnosis and obstetric outcomes was observed, in particular the modality of childbirth and perineal outcomes.
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: this paper contributes new knowledge to the body of literature around the EPU phenomenon during labour and midwifery practices adopted in response to it. Overall, it could be argued that EPU is a physiologic variation in labour if maternal and fetal conditions are good. Midwives might suggest techniques to woman to help her to stay with the pain, such as change of position, blowing breath, vocalisation and use of the bath. However, the impact of policies, guidelines and culture on midwifery practices of the specific setting are a limitation of the study because it is not representative of other similar maternity units. Thus, a larger scale work should be considered, including different units and settings. The optimal response to the phenomenon should be studied, considering EPU at different dilatation ranges. Future investigations could also focus on qualitative analysis of women and midwives’ personal experience in relation to the phenomenon.
Citation
Borrelli, S. E., Locatelli, A., & Nespoli, A. (2013). Early pushing urge in labour and midwifery practice: A prospective observational study at an Italian maternity hospital. Midwifery, 29(8), https://doi.org/10.1016/j.midw.2012.09.010
Journal Article Type | Article |
---|---|
Acceptance Date | Sep 29, 2012 |
Online Publication Date | Feb 13, 2013 |
Publication Date | Aug 1, 2013 |
Deposit Date | Jan 19, 2017 |
Publicly Available Date | Jan 19, 2017 |
Journal | Midwifery |
Print ISSN | 0266-6138 |
Electronic ISSN | 1532-3099 |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 29 |
Issue | 8 |
DOI | https://doi.org/10.1016/j.midw.2012.09.010 |
Keywords | Early pushing urge; Labour; Second stage; Midwifery practice |
Public URL | https://nottingham-repository.worktribe.com/output/715988 |
Publisher URL | http://www.sciencedirect.com/science/article/pii/S0266613812001805 |
Contract Date | Jan 19, 2017 |
Files
EPU quantitative study (Nottingham ePrint).pdf
(325 Kb)
PDF
Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0
You might also like
What is a good midwife? Some historical considerations
(2013)
Journal Article
What is a good midwife? Insights from the literature
(2013)
Journal Article
Early labour midwifery care in Italy: local and cross-cultural challenges
(2014)
Journal Article
Midwives’ approaches to early pushing urge in labour
(2015)
Journal Article
First-time mothers’ experiences of early labour in Italian maternity care services
(2015)
Journal Article
Downloadable Citations
About Repository@Nottingham
Administrator e-mail: discovery-access-systems@nottingham.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search