Birth Position Research Articles

Costs and intermediate outcomes for the implementation of evidence-based practices of midwifery under a MIDWIZE framework in an urban health facility in Nairobi, Kenya

BackgroundThree evidence-based midwife-led care practices: dynamic birth positions (DBP), immediate skin-to-skin contact (SSC) with zero separation between mother and newborn, and delayed cord clamping (DCC), were implemented in four sub-Saharan African countries after an internet-based capacity building program for midwifery leadership in quality improvement (QI). Knowledge on costs of this QI initiative can inform resource mobilization for scale up and sustainability. MethodsWe estimated the costs and intermediate outcomes from the implementation of the three evidence-based practices under the midwife-led care (MIDWIZE) framework in a single facility in Kenya through a pre- and post-test implementation design. Daily observations for the level of practice on DBP, SSC and DCC was done at baseline for 1 week and continued during the 11 weeks of the training intervention. Three cost scenarios from the health facility perspective included: scenario 1; staff participation time costs ($515 USD), scenario 2; staff participation time costs plus hired trainer time costs, training material and logistical costs ($1318 USD) and scenario 3; staff participation time costs plus total program costs for the head trainer as the QI leader from the capacity building midwifery program ($8548 USD). ResultsAt baseline, the level of DBP and SSC practices per the guidelines was at 0 % while that of DCC was at 80 %. After 11 weeks, we observed an adoption of DBP practice of 36 % (N = 111 births), SSC practice of 79 % (N = 241 births), and no change in DCC practice. Major cost driver(s) were midwives’ participation time costs (56 %) for scenario 1 (collaborative), trainers’ material and logistic costs (55 %) in scenario 2(collaborative) and capacity building program costs for the trainer (QI lead) (94 %) in scenario 3 (programmatic). Costs per intermediate outcome were $2.3 USD per birth and $0.5 USD per birth adopting DBP and SSC respectively in Scenario 1; $6.0 USD per birth adopting DBP and $1.4 USD per birth adopting SSC in Scenario 2; $38.5 USD per birth adopting DBP and $8.8 USD per birth adopting SSC in scenario 3. The average hourly wage of the facility midwife was $4.7 USD. ConclusionImproving adoption of DBP and SSC practices can be done at reasonable facility costs under a collaborative MIDWIZE QI approach. In a programmatic approach, higher facility costs would be needed. This can inform resource mobilization for future QI in similar resource-constrained settings.

Inviting Newton to Visit the Delivery Room. The Role of Gravity During Childbirth.

Throughout history, the upright position was the norm for most deliveries. However, due to cultural reasons, this practice was changed in the 17th century, and since then, the majority of deliveries have been conducted with the parturient lying on her back. The aim of this review article is to challenge the nowadays recumbent birth position and to emphasize the added value of gravity to the childbirth. Physiologically there is a strong argument for delivering in an upright position due to the significant role of gravity. The baby's presenting part does not move back between contractions as happens in today's recumbent position when due to the anatomy of the pelvis, the presenting part moves uphill. In this position, the second stage is shorter, and the signal for active pushing occurs spontaneously. It is recommended that any parturient should be informed about the risks and benefits of each birthing option to decide the birthing position that suits her.

Effect of Upright Positioning on the Process and Outcome of Labour Among Parturient in Primary Health Care Setting

Introduction The position of the woman during labour is an essential part of maternal care, but some care providers often neglect it. There are also some recommended birthing positions, but there is a lack of data on how midwives translate the findings into practice. Objective This study aimed to compare upright and supine births concerning the birth process and outcomes among women who have given birth in primary health care settings. Material and Methods This is a quantitative comparative study among parturient in primary health care setting. An observational checklist was used as a data collection tool. A total of 40 parturient (20 each for upright and recumbent position groups) were selected as the study participants. Data were analysed using an independent t-test and chi-square test. Results Findings indicated that although the uterus contracts more frequent in an upright position, there was no substantial difference between the groups concerning the progress of labour ( p > .05). However, findings suggested that the upright position is associated with a shorter duration in the third stage of labour compared to the recumbent position ( p < .05). Blood lost was <500 mils for 75% of the upright position and 55% of the recumbent position group ( p = .054). Conclusion Upright position may shorten the duration of the third stage of labour (compared to recumbent position) among parturients. Hence, midwives can utilise the upright/vertical protocol during their practice to ensure better outcome of the labour and minimise blood loss for the parturient.

Determination of the Level of Prevalence of Disrespect and Abuse of Women during Child-Birth in the Major Hospitals in Yenagoa, South-South Nigeria

This study aimed to determine the level of disrespect and abuse of women during childbirth in two hospitals in Yenagoa metropolis in South-South Nigeria. It was a cross-sectional survey carried out on 165 mothers who delivered within 6 weeks (August and September 2018), using a purposive sampling method. Data was collected using the Level of Disrespect and Abuse of Women during Childbirth Scale (LDAWCS). Prevalence of disrespect and abuse during childbirth in selected hospitals was low with 26.7 % (n=44) of women experiencing at least one form. The most frequent types of D&A were; detention for non-payment of bills 50.3% (n=83), women never allowed to choose a birthing position, carrying out procedures without consent 39.4% (n=65), women left naked in the view of many staff 29.7% (n=49) and women abandoned during labour 21.2% (n=35). There was a significant relationship between disrespect and demographic characteristics of parity and education, marital status, ethnicity, income and occupation had moderate evidence of a relationship with disrespect and abuse while age and religion showed no significant relationship with D &A at α = 0.05 level of significance. National human rights commission should look into cases of D & A of women and they should be encouraged to report such cases as they leave the premises for proper action to be taken. Professional bodies like the Nursing/Midwifery Council of Nigeria, Nigeria Medical Association etc., should investigate and institute disciplinary action against any member found to have disrespected and abused women during childbirth.

Explaining the Link Between Paternal Socioeconomic Position and Small for Gestational Age Birth: The Effect of Maternal Unhealthy Behaviors.

To determine the proportion of small for gestational age (weight < 10th percentile, SGA) births among fathers with lifelong low (compared to high) socioeconomic position (SEP) attributable to white and African-American women's unhealthy pregnancy-related behaviors. Oaxaca-Blinder decomposition methods were conducted on the Illinois transgenerational dataset of infants (1989-1991) and their Chicago-born parents (1956-1976) with appended US census income data. The neighborhood income of father's residence at the time of his birth and at the time of his infant's birth were used to estimate his lifetime SEP. Maternal unhealthy pregnancy-related behaviors were defined as cigarette smoking, inadequate prenatal care, and/or low weight gain during pregnancy. Among African-American women, births (n = 4426) to fathers with lifetime low SEP had an SGA rate of 14.8% compared to 12.1% for those (n = 365) born to fathers with lifetime high SEP (p < 0.0001). Among white women, births (n = 1430) to fathers with lifetime low SEP had an SGA rate of 9.8% compared to 6.2% for those (n = 9141) born to fathers with lifetime high SEP (p < 0.0001). Adjusting for maternal age, marital status, education, and parity, African-American and white women's unhealthy pregnancy behaviors accounted for 25% and 33%, respectively, of the disparity in SGA rates among infants of lifetime low (compared to high) SEP fathers. A significant proportion of the disparity in SGA rates between fathers with lifelong low (compared to high) SEP is explained in both races by maternal unhealthy pregnancy behaviors.

Effects of flexible sacrum position at birth on maternal and neonatal outcomes: A retrospective cohort study.

To examine the differences in both maternal and neonatal outcomes between flexible and non-flexible sacrum positions at birth. A descriptive, cross-sectional, retrospective study was carried out on a sample oflow-risk pregnant women. Univariate and multivariate logistic regressions and multivariate linear regressions were conducted to estimate the association between our discrete or continuous variables of interest. Maternal outcomes were perineal tear, maternal blood loss, second stage length; neonatal outcomes were Apgar scores and neonatal asphyxia. Results were adjusted for maternal age, neonatal birth weight, and epidural analgesia. We considered for final analysis 2198 women. In primiparous women, women giving birth in the all-fours position were significantly more likely to have an intact perineum (P = 0.011) and a shorter length of the second stage of labor (P = 0.022). Maternal age (P = 0.005) and neonatal weight (P = 0.013) significantly increased perineal tearing; maternal age (P = 0.004) and neonatal birth weight (P < 0.001) were significantly associated with a higher amount of blood loss. Maternal age (P = 0.002) and neonatal weight (P < 0.001) significantly increased the length of the second stage of labor. For multiparous women, the side-lying position was significantly correlated with an intact perineum (P = 0.031); maternal age and intact perineum were statistically inversely associated. Epidural analgesia significantly increased the length of the second stage of labor in both nulliparous (P < 0.001) and pluriparous women (P < 0.001). No significant differences were found in neonatal outcomes. Women with a low-risk labor should be free to choose their birth position as flexible sacrum positions are shown to increase maternal well-being and do not affect neonatal health.

UNDERSTANDING THE PHENOMENON OF LABOUR ROOM VIOLENCE AGAINST PREGNANT WOMEN: PERCEPTIONS AND PRACTICES OF HCP'S AND CHANGES AFTER RMC PRACTICES

Objectives: To understand the phenomenon of labour room violence against women and HCP's perceptions of behaviours constituting mistreatment in labour room, to study the factors responsible for mistreatment in labour rooms and to study the changes after training of RMC practices. Methods: This study analyses mixed-methods data obtained through systematic clinical observations and open-ended comments recorded by the observers to describe care and in -depth interview to capture HCPs perception of labour room violence. Findings: There are 7 major categories of disrespect and abuse that women encountered during childbirth in health facilities which are verbal abuse, non-consented clinical care, non-condential care (including denial of privacy), non-dignied care, discrimination based on specic patient attributes, abandonment or denial of care and detention in facilities.(1) According to the present study, these forms of mistreatment has been drastically reduced in our institute in addition to which good RMC practices are adopted, so that a woman can experience decent &amp; ethical but an honourable start towards her motherhood. Conclusions: Training of HCPs to understand the concept of respectful maternity care, development of a handbook with standard operating protocols(14) for women in labour, introduction of different birthing positions as well as birth companions were described as key components to inculcating respectful maternity care. The programme was on going one, with respectful maternity care practices being passed on from older to newer staff through a system of continuous teaching and guidance on the job, hence institutionalising these new practices through constant engagement, supervision and incremental.

​​Fleshy Entanglements in Development Aspirations​: Birth Position as a Site of Contestation in Bangladesh

Encouraging women to adopt a position of their choice during birth has long been among the calls of scholars and activists challenging medicalised models of childbirth rooted in patriarchy to allow women to own their birthing experiences rather than accept the passivity of a lithotomy position. The encouragement of women to adopt a position of their choosing is now integrated within global health policy. Based on fieldwork conducted in Dhaka and Kushtia district, Bangladesh, this article examines the promotion of non-supine birth positions promoted through international development entities in Bangladesh. It argues that despite its emancipatory appeal, when subsumed by international development logics, the birth position operates as a site of political contestation in which women are rendered peripheral within a broader constellation of development imaginaries and ends. Within this constellation, the birth position is circumscribed as a technical intervention amenable to metricisation. Rather than a ‘return’ to more ‘natural’ forms of birth, ‘non-supine’ birth positions when instrumentalised in this context, are broadly conceived of as ‘foreign’, and serve to expand the medicalisation of childbirth.

Alternative Birthing Positions Compared to the Conventional Position in the Second Stage of Labor: A Review.

The position in which the woman delivers has a lot of impact on the ease of delivery.Women's satisfaction with their birthing experience and the care they receive is significantly impacted by the fact that giving birth is frequently a challenging experience. Birthing positions refer to various postures which can be assumed at the time of delivery by a pregnant woman.Currently, the majority of women give birth either while lying flat on their backs or in a semi-sitting position.Upright positions, which include standing, sitting, or squatting along with side-lying and hands-and-knees, are less common birth positions. Doctors, nurses, and midwives are among the most important healthcare professionals, having a significant influence in deciding which position the woman will give birth in and on the physiological and psychological effects of the experience of a woman in labor. There isn't much research to back up the best position for mothers during the second stage of labor. This review article aims to review and compare the advantages and risks of common birthing positions and know about the knowledge of alternative birthing positions among pregnant women.

Visualization of fast ion phase-space flow in plasmas well-below, near and well-above Alfvén eigenmode stability threshold in tokamak

Transport of fast ions along certain local phase space paths, referred to as fast ion phase-space flow, has been systematically measured by an imaging neutral particle analyzer (INPA) in three plasma regimes, which are well-below, near, and well-above the Alfvén eigenmode stability threshold (Du et al 2021 Phys. Rev. Lett. 127 235002). (1) In plasmas well-below the Alfvén eignenmodes (AE) stability threshold, fast ions are well-confined on passing particle orbits without noticeable transport over the phase space. The observed INPA images agree well with the synthetic INPA images, using the fast ion distribution predicted by neoclassical theory. (2) In plasmas near the AE stability threshold, INPA images in the presence of AE activity moderately deviate from those without AE activity. The image difference can be well interpreted by AE-driven, phase-space fast ion flow. Paths of this flow over the velocity space (or streamlines) are reconstructed by the intersection lines of curved Eʹ and µ surfaces, referred to as Eʹ and µ line (where ; E, P ζ and µ are the energy, canonical toroidal momentum and magnetic moment of ions; ω and n are the angular frequency and toroidal mode number of AEs, respectively). Resonant fast ions move radially inward by gaining energy and move radially outward by losing energy and the trajectory well aligns with the Eʹ and µ lines that pass through the mode resonances near the injection energy of neutral beams. (3) In plasmas well-above the AE stability threshold, fast ion phase-space dynamics shows additional features. Fast ions are transported out of the birth positions so promptly along the streamlines that the slowing-down process from the injection energy is not observable, exhibiting strong critical gradient behavior at local phase space. As a result, the increase of electron temperature is very small, in spite of an increase of beam power by . It should be emphasized that the directions of phase-space transport, induced by AEs with different frequencies, structures and mode numbers, do not largely differ.

Birth process of electron-positron pairs inside supercritical fields

We propose a computational quantum field theoretical approach to obtain a microscopic insight into the creation process of electrons and positrons as well as their subsequent motion inside a supercritical external field with space-time resolution. A machine-learning–based method permits us to address fundamental questions such as where inside the interaction region the particles are being created and what their initial velocity distribution is. It suggests that the particles' most likely birth positions change in time during the dynamics. At early times the particles' birth density is roughly proportional to the square of the force field, but in the long-time and steady state production regime their possible birth locations narrow down significantly. Counterintuitively, this leads for longer times to the occurrence of “birth-free” zones within the field, where particles are no longer created even though the electric field is maximal there. The genetic-programming–based symbolic regression algorithms first learn multiple sequences of partially dressed positronic spatial probability densities as training data and then exploit their features as a function of the dressing strength in order to predict the particles' true distribution in space and momentum.

A Study of Relative Age Effect in Professional Leagues (The Sample of Turkish Super League, 1st League, 2nd League and 3rd League)

This present study aims to examine the phenomenon of the relative age effect among football players based on birth year and the positions they played in Turkish professional leagues. A total of 3622 professional football players from Turkish Super League, Spor Toto 1stLeague, 2ndLeague and 3rd League were included in the study. The players were divided into 4 different quarters with 3-month intervals and 2 different half-terms with 6-month intervals starting from January. The data of the second half of the 2021-2022 football season were used in the research. The data of the study were obtained from the official and open-access web pages of the Turkish Football Federation and Transfermarkt. With the chi-square test, the distribution of the football players according to birth months, positions and leagues and the frequency distribution differences between the groups were analyzed. SPSS 22 statistical package program was used to analyze data and the significance level was accepted as p&amp;lt;0.05. As a result, it has been observed that the number of football players born in the first quarter and the first 6 months of the year in all of the professional leagues in Turkey is more than the players born in the other quarters of the year, and the results were found statistically significant. In addition, it has been determined that there are more football players born in the first months of the year in all positions according to the leagues. As a result, the presence of relative age effect in football players playing in professional leagues in Turkey has been revealed.

Study of the open clusters in Kepler prime field

ABSTRACTWe present a detailed study of NGC 6791, NGC 6811, NGC 6819, and NGC 6866, the four open clusters that are located in the Kepler prime field. We use new CCD UBV(RI)KC photometry, which was combined with Gaia EDR3 photometric/astrometric data, to derive the astrophysical parameters with two-independent methods – one of them the fitCMD algorithm. Furthermore, we provide among others estimates of the mass and mass function, the cluster structure, derive the cluster orbits, and discuss the cluster dynamics. All objects belong to the older open cluster population (∼1–7 Gyr), are in an advanced dynamical stage with signs of mass segregation, and are located close to the solar circle, but show a large range in respect of radii, member stars or observed cluster mass ($\sim 100\!-\!2000\, \mathrm{M}_\odot$). For the three younger objects, we were also able to provide photometric metallicity estimates, which confirms their status as clusters with a roughly solar metallicity. The most outstanding object is clearly NGC 6791, a very old cluster with a high metallicity at a distance of about 4.5 kpc from the Sun. We estimate a probable radial migration by about 7 kpc, resulting in a birth position close to the Galactic centre.

Pregnant Women’s Preferred Birthing Positions In A Tertiary Health Facility In Cross River State, Nigeria

Objective: In recent times, there have been a shift in the focus of health sector towards respectful maternity care. The concept of respectful maternity care is inclined towards client centred care with the right of women to make informed decisions concerning birth choices. The right of a woman to decide which position to adopt during childbirth has been limited the supine position in most maternity service centres and hospital settings. This study sought to investigate pregnant women’s preferred birthing positions in a tertiary health care facility in Calabar, Cross River State, Nigeria&#x0D; Materials and methods This study utilized the descriptive cross-sectional design to recruit 169 pregnant women using the purposive sampling techniques. The instrument for data collection was a structured and validated questionnaire.&#x0D; Results: Finding showed that 89.3% had good knowledge on birthing positions. Also, a good number of participants preferred the squatting position and position change as they deem comfortable during childbirth. Supine positions where the least preferred. Additionally, most participants agreed that level of education, age, previous childbirth familiarities, place of birth and support from midwives were factors that could influenced their choice of birthing positions.&#x0D; Conclusion: Based on these findings, the researchers recommended that midwives update their knowledge on the different birthing positions in order to educate and assist pregnant women who may desire these positions during childbirth. This will encourage the utilization of Skilled Birth Attendants (SBAs) which will help reduce maternal morbidity and mortality that would occur during childbirth on the overall.

Timing of cord clamping: An observational study of cord clamping practice in a maternity hospital in Aotearoa New Zealand

Background: When the umbilical cord is left unclamped after birth, a significant proportion of the blood from the placenta flows into the newborn, increasing the baby's blood volume by approximately 30%. Routine intervention of immediate cord clamping is harmful as it deprives the newborn access to their own blood, resulting in impaired physiological transition at birth and lower iron stores in early infancy. Iron deficiency in early life, even without anaemia, is linked with impaired neurodevelopment. Aim: The aim of this study was to accurately record birth to cord clamping interval at term vaginal births in a tertiary hospital in Aotearoa New Zealand and concurrently to examine some of the circumstances that may influence the timing of when the cord is cut. Method: This observational study was undertaken from August 2017 to April 2018. Participants were pregnant women having a vaginal birth at ≥37 weeks gestation. Data collected included birth to cord clamping interval, mode of birth (spontaneous or instrumental), maternal position for birth and practitioners involved in the birth. Descriptive statistics were used to summarise the data. Results: Participants were 55 women with term vaginal births. The median interval between birth and cord clamping was 3.5 minutes (IQR 2.18 - 5.68 mins). There was a longer median cord clamping time in the group who had a spontaneous birth (median 3.71; IQR 2.67 - 6.23) vs instrumental birth (2.08; IQR 0.55 - 2.30); with maternal side-lying position (6.37; IQR 4.15 - 9.48) vs lithotomy position (2.24; IQR 1.87 - 3.50); with midwife-facilitated birth (4.06; IQR 2.68 - 6.65) vs obstetric-facilitated birth (2.13; IQR 1.48 - 3.28); and when the neonatal team was not called to attend (4.73; IQR3.32 - 8.26) vs when they were called to attend (2.13; IQR 1.28 - 3.27). Discussion: The median cord clamping time of 3.5 minutes aligns with current local, national and international guidelines, although clamping times as short as 0.23 minutes were observed. The study provides a snapshot of practice at one tertiary hospital, examining data on a range of vaginal births, from uncomplicated midwifery-led births to complicated obstetric-led births requiring neonatal team attendance. By identifying some of the circumstances where cords are clamped early, we may be able to modify the associated factors for these births, thereby improving newborn health outcomes in the future.

Sibling Position and the Development of Social Skills among Children

Purpose: This article examines the role sibling position (birth order) plays in the development of social skills. Given that the family is the first social system a child gets exposed to, it is assumed that the child’s birth position and the relationships that exist among family members plays a substantial role in their development of social skills. The paper focuses on three birth positions: first borns, last borns and only child. The study thus aims to examine whether the a fore mentioned birth positions influences a child’s tendency to communicate and relate with others. Does one’s birth position influence his or her tendency to communicate and relate with others?&#x0D; Methodology: It is a conceptual paper that employs a meta-analytic approach to review, synthesize and draw conclusions from existing literature on sibling position specifically the first born, last born and only child and the effect such positions have on the development of social skills.&#x0D; Findings: It was realized that first borns perceive themselves as being treated differently from later children, are accustomed to being the centre of attention and tend to be high achievers. Last borns are perceived to be creative, outgoing, extraverted, disobedient and tend to resist the authority of the bigger siblings. They exhibit interpersonal skills but have an abnormally strong feeling of inferiority as result of being over pampered by their seniors. Only children are not independent and have difficulty in delaying gratification. They demand much love from their partners with unwillingness to reciprocate. They are also most often self-centred, maladjusted, unlikable, anxious and dependent on others. The degree to which people tend to relate and communicate with others is influenced to some extent by their birth order. &#x0D; Unique Contribution to Theory, Practice and policy: It is thus vital to minimize certain cultural attitudes exhibited by parents, siblings and other family members in the course of socialization at home that can deter the development of social skills in children. This is supported by Bandura’s (1978) Theory of Observational Learning, as children learn or model behaviours from especially elderly siblings and other caregivers; Bowlby's (1969/1982) attachment theory which maintains that patterns of relating are built upon the early interactions between the primary caregiver and the child.

Fizyolojik doğum savunucuları: Türk ebelik öğrencilerinin doğal doğum algıları

&#x0D; &#x0D; Objective: The aim of this study is to examine the views of students studying in the midwifery department about the perception of birth. Method: A cross sectional descriptive study. The study was carried out using an online questionnaire, which was prepared by researchers in accordance with the current literature, evaluating students' perception of childbirth. Results: 484 undergraduate midwifery students (mean age, 20.94±2.35 years) agreed to participate in the study. Approximately 90% of the students reported that they have heard the concept of natural birth. The findings showed that 61% of the students have heard the term of natural birth at the university. The percentages of students who disagree with the presence of the freedom of movement of a pregnant woman, the usefulness of music, bath and massage at birth, the effectiveness of relaxation techniques or entering to water at the body temperature at birth, supporting to other birth positions instead of supine and preference of vertical positions during active delivery, were higher in the first-year midwifery students compared to other students. Conclusion: It is recommended that create in-service training programs are created for the student midwives to access up-to-date information after graduation, to provide the integration of the theoretical information given to the students to the clinical environment, and to carry out visual and cohort studies on the subject. In line with the findings obtained from the study, additions can be made to the midwifery education curriculum.

Development of a Model to Determine the Purchase Intention of Counterfeit Luxury Products Among Consumers in Bengaluru

The luxury fashion industry is a profitable one and is expected to grow at a rate of 10.99% annually. With the luxury industry growing, the counterfeiting industry is also seeing rapid growth. India’s trade has increased by 24% in the last two years. The research attempted to investigate the factors affecting consumers’ attitudes toward the purchase intention of counterfeit luxury products in South-East Bengaluru. The primary data were collected through an online survey questionnaire. Using the cluster sampling technique, a total of 309 responses were received, of which seven were rejected due to incomplete responses. Therefore, a sample size of 302 was seen fit to use for statistical purposes. Based on the identified factors, initially, a conceptual framework was developed, and the model was tested using JMP Pro 16 software. The research findings revealed that low -income group consumers tended to buy counterfeits more often. The ordinal position of birth played a significant role where first-born children showcased an unfavorable attitude. However, later-born children showcased a more positive attitude. Young adults showed an approved attitude toward counterfeits. The social class of students and employees showed an encouraging attitude toward counterfeits. Several personal and social factors were found to have a strong influence on the attitude toward counterfeits. From the findings, suggestions and recommendations have been drawn to assist genuine brands to frame better tactics to curb counterfeiting.

Expectations of the upcoming birth – A survey of women’s self-efficacy and birth positions

BackgroundAdopting an upright sacrum flexible position may facilitate physiological childbirth, which many pregnant women wish for. A positive association between women’s choice on birthing position and birthing experience has been found. ObjectiveThe aim of this study was to examine women’s preferred birth position, self-efficacy at term and their actual birth position at time of birth. MethodsA survey of 554 pregnant Danish women at gestational week 38. Data was collected using an online survey and information was retracted from the woman’s medical record. Descriptive statistics and non-parametric tests were used and univariate and multivariate logistic regression models were used to analyse the association between self-efficacy and fulfilled wish of birth position. FindingsThe majority of women (>70 %) wished to give birth in a sacrum flexible position but more than 80 % gave birth in a non-flexible position. Less than 50 % had their wish of birth position fulfilled. All women reported overall high self-efficacy. No difference in having wish for birth position fulfilled was found comparing women with high and low self-efficacy. ConclusionsMost women wished for a sacrum flexible position but more than 80% gave birth in a sacrum non-flexible position and less than 50% had their wish for birth position fulfilled. Level of self-efficacy did not affect the likelihood of having wish of birth position fulfilled indicating that the culture at the birth setting and skills and attitudes among birth providers may have a considerable impact on women’s choice of birth position.

Twin birth: The maternal experience

ObjectiveTwin birth is a special setting for women giving birth, and the experience of childbirth can be different from singleton birth. The objective of this study was to evaluate and compare the childbirth experiences of twin mothers and singleton mothers. We also aimed to identify the risk factors of a negative childbirth experience in the whole study population. MethodsAll live diamniotic twin deliveries in the study hospital of at least 35+0 weeks of gestation with a plan of vaginal birth were included in this matched groups study from August 2015 to August 2019. For every twin birth, two singleton birth controls were selected and matched with parity, the actual mode of birth, and gestational weeks at birth. Six weeks after birth, a Childbirth Experience Questionnaire (CEQ) was sent to mothers, and 72 twin mothers and 126 singleton mothers returned the questionnaire. ResultsThe twin mothers’ overall childbirth experience was positive. They reported a significantly lower opportunity to choose the birthing position (p < 0.001). Otherwise, there were no differences in the CEQ mean total scores between the study groups. Intrapartum cesarean section raised the risk of a negative childbirth experience and there was a high level of satisfaction with midwifery care among the whole study population. ConclusionThe overall maternal experience in planned vaginal twin birth was positive. Twin mothers felt less often able to choose their birthing position, otherwise the childbirth experience did not differ from that of singleton mothers.