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Positions during the first stage and the passive second stage of labor: A survey of French midwives

Abstract : Objective: the objective of our study was to describe the practices reported by French midwives during labor (first stage and passive phase of the second stage). Design: this cross-sectional internet questionnaire surveyed French midwives who attended at least one delivery in 2013. Setting: this open survey was posted on a website from June 15 through December 1, 2014. Participants: 1496 midwives from 377 maternity units participated in the study. Nearly 93% of the midwives worked in an obstetric unit, 5.9% had a mixed practice, and 1.3% worked in private practice. Measurements and findings: during the first stage of labor, midwives reported suggesting that women without epidural analgesia use a birthing ball (98.1%) and that they walk around (97.4%). For women with epidural analgesia, most suggested motion in horizontal positions. Epidural analgesia was proposed more often by midwives from level II (75.7%) and level III (73.5%) maternity wards than by those at level 1 units (57.7%) (p<0.0001). The midwives preferred a lateral position during the first stage for women with epidural analgesia and during the second stage for women both with and without it. Midwives in practice for 5 years or less suggested a kneeling position for women with epidural analgesia more often than more experienced midwives. Key conclusion: the practices of French midwives vary with their place of practice and their experience. Implications for practice: to promote normal labor, French midwives must reappropriate vertical positions and analgesic alternatives to epidurals.
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Submitted on : Thursday, November 30, 2017 - 5:08:33 PM
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Chloé Barasinski, Anne Debost-Legrand, Didier Lemery, Françoise Vendittelli. Positions during the first stage and the passive second stage of labor: A survey of French midwives. Midwifery, Elsevier, 2018, 56, pp.79-85. ⟨10.1016/j.midw.2017.10.010⟩. ⟨hal-01652817⟩

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