Karin
How did you define lithotomy position exactly? With legs in stirrups?
Ellen
----- Original Message -----
From: "Karin Gottvall" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, January 20, 2008 3:46 PM
Subject: severe lacerations
> Rachel,
> Please give me the references.
>
> Third and fourth degree lacerations and maternal position at second stage
> of
> labour have been studied in Sweden among more than 12 000 vaginal,
> non-instrumental birth. The results showed that lithothomy position (used
> in
> 21% of all births) was most harmful, also when adjusting for already known
> riskfactors. As a midwife we have an influence over the birthposition and
> are able to encourage the mother to use a position she feel comfortable
> in,
> I do not think many women choose a lithtomy pos.
> In other countries which position is most common and do you have any
> evidence which is the "best" from the mothers point of view.
>
> Karin
> Ref: Risk factors for anal sphincter tears: the importance of maternal
> position at birth. BJOG. 2007 Oct;114(10):1266-72.
>
>
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> Från: A forum for discussion on midwifery and reproductive health
> research.
> [mailto:[log in to unmask]] För Rachel Reed
> Skickat: den 20 januari 2008 06:25
> Till: [log in to unmask]
> Ämne: Re: water birth
>
> I have just completed a literature review as part of my PhD. I thought I'd
> summarise the findings re.
> hands on and hands off. If anyone would like the refs or more detail let
> me
> know.
>
> There is no evidence that hands on reduces perineal tearing. There is some
> evidence to associate
> hands on techniques with 3rd degree tears. Most risk factors for perineal
> tearing are fixed and
> cannot be controlled by the mw ie. size of baby, ethnicity, etc.
>
> One of the benefits of a waterbirth is that the mw can't get in and fiddle
> with the emerging baby.
> There is evidence that when women are left to follow their own urges they
> birth in the best way for
> themselves and their babies (and protect their own perineum).
>
> We need to stop blaming ourselves and colleagues for 3rd degree tears and
> start trusting in the
> physiological process of birth.
>
> Rachel
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