Physiological Birth Research Articles

Delivery-Associated Changes in the Levels of Inflammatory Molecules in Newborns.

Inflammation is considered a fundamental process accompanying physiological human birth, also playing a role in perinatal pathologies. The goal of the study was to assess the concentrations of inflammatory molecules with respect to the mode of delivery and dynamics of inflammatory molecules in neonatal samples in the first 48-72 hours of life. The concentrations of inflammatory cytokines were measured using the Luminex®xMAP multi-analyte profiling platform in cord blood and peripheral neonatal blood. Study groups included newborns delivered spontaneously (spontaneous group) and via elective caesarean section (elective group). Cord blood concentrations of interleukin 6 (IL-6) and procalcitonin were significantly higher (P < 0.0001) in the spontaneous group compared to the elective group. Neonatal blood concentrations of tumour necrosis factor (TNF) from the elective group were significantly higher com-pared to the spontaneous group (P = 0.0077). The concentrations of procalcitonin and TNF significantly increased within the first 48 to 72 hours following either mode of delivery. IL-6 and IL-18 were significantly higher in neonatal compared to umbilical cord blood in the elective group only, while the increase in the spontaneous group did not reach statistical significance. The concentrations of IL-1α, IL-1β, IL-17A and IL-22 did not show significant differen-ces between the spontaneous and elective groups as well as between umbilical cord and neonatal blood. Our findings show physiological differences in the levels of inflammatory molecules following spontaneous vaginal delivery and elective caesarean section. The results can be used as baseline values for the research of various pathologies in newborns.

Implementing an Undergraduate Nursing Elective Advanced Perinatal Course and Its Effect on Perceived Perinatal Nursing Knowledge and Self-Efficacy Levels of Students Who Aim to Enter a Perinatal Specialty as New Graduate Nurses

Nursing schools face challenges within maternal/newborn practicum courses for undergraduate nursing students, such as a lack of consistent clinical sites or experiences that capture the high acuity needs of perinatal environments. Additionally, perinatal units face challenges in orienting and retaining new graduate nurses, while new graduate nurses entering perinatal units may be likely to experience feelings of insecurity or self-doubt due to perceived inadequate preparation for such specialties (Lesher et al., 2021). There are multiple negative impacts that may stem from a lack of confident and competent novice perinatal nurses. The rise in maternal morbidity and mortality rates in the United States are of particular concern, and knowledge gaps on behalf of novice perinatal nurses may result in the lack of skills and confidence in recognizing complications and intervening appropriately, potentially jeopardizing patient safety. The literature suggests that perinatal units face challenges in effectively orientating new graduate nurses, leading to burnout and financial burdens (Dickerson et al., 2022). Recognizing the potential benefits of improving preparation for students interested in entering a perinatal specialty as new graduates, such as improved patient outcomes and increased staff retention, this study aims to analyze the impact of an elective advanced perinatal course on student perception of knowledge and self-efficacy levels for those who aim to enter a perinatal specialty as a new graduate nurse. Content will be focused on advancing knowledge of normal physiologic birth, high-risk obstetrical and newborn considerations, obstetric emergencies, perinatal mood and anxiety disorders, bereavement care, diversity/equity/inclusion care, and resiliency tips.

Measurements of the Female Pelvis and the „Artificial Premature Birth“ in the 19th Century – an Object-Centered Study Based on the Collection of the University Women’s Clinic in Würzburg

The collection, measurement and precise mapping of the female pelvis served to investigate the physiological birth process and its pathological deviations. Academic obstetricians considered the narrowed pelvis to be a great challenge, which made childbirth difficult and, in the worst case, endangered the life of mother and child. The article not only examines the obstetric practice of measuring the female pelvis through the scientific research of the Würzburg collection of pelvic preparations and pelvic measuring instruments. Rather, it discusses the ethical problems that arose for academic obstetricians from the measurement values that deviated from the newly defined norm. Closely connected to the history of pelvic research – so the argument – is that of „artificial premature delivery“, which has received little attention in the history of obstetrics.

TRANSFORMING FROM DOULA TO MIDWIFE

The roles of doulas and midwives converge in some areas, yet their divergences are vast. Transitioning from doula to midwife has given me an insider’s view, enabling me to reflect on the advantages and challenges of these vocations and the benefits of merging these skills. Providing continuity and woman-centred care in an emotionally-safe environment is a skill both doulas and midwives can develop. However, the variations in responsibilities and regulations can create discord, interfering with a woman’s experience, autonomy in decision-making and empowerment. When women’s voices are heard and philosophies align, doulas’ and midwives’ skills in supporting physiological birth are protective against over-medicalisation and iatrogenic trauma.

Seeing Birth in a New Light: How Exposure to Homebirth Transforms Midwives’ Understanding of Physiological Birth

Since the 19th Century, hospital has been considered the default place of birth for Australian women, with the vast majority of women giving birth in hospital labour ward settings. Currently in Australia, less than 1,000 women give birth at home each year, with homebirths representing just 0.4% of all births in 2020.1 As such, many maternity-care providers have never been exposed to homebirth in their personal or professional lives, making them unfamiliar with this unique birth setting.

Study of the possibility of osteopathic correction inclusion in the complex therapy of pelvic pain syndrome in women at the late postpartum period

Introduction. Pain during childbirth and pain after childbirth are unavoidable. Most often, the occurrence of pelvic pain syndrome after childbirth is associated with the manifestation of physiological changes in the joints and bones of the pelvis during pregnancy and during childbirth. The musculoskeletal system of a woman after childbirth passes to normal functioning gradually, and some stages of this process may be accompanied by pain syndrome of various localization and severity. In the late postpartum period and during lactation, non-drug treatment of pain syndrome is preferable. One of the promising non-drug approaches may be the timely application of osteopathic correction methods. However, the available scientific literature presents relatively few studies on the possibility of osteopathic methods using for the pelvic pain syndrome correction in women at the postpartum period.The aim of the study was to research the possibility of osteopathic correction inclusion in the complex therapy of pelvic pain syndrome in women at the late postpartum period.Materials and methods. A group of women after physiological childbirth was randomly formed homogeneous by age, parity of childbirth. The study involved 40 primiparous women aged 30–40 years with no organic diseases, and with the presence of pelvic pain syndrome, which first appeared in the late postpartum period (2–8 weeks after physiological birth through the natural birth canal). Two groups were formed by the randomization envelopes method: the main group (20 participants) and the control group (20 participants). In both groups, the patients received therapy in the form of applications of anesthetic ointments (gels), the use of the Lyapko applicator, elements of therapeutic physical culture (static gymnastic exercises in the supine position). Patients of the main group additionally received osteopathic correction (3 sessions with an interval of 10–14 days). Before and after treatment, osteopathic status, quality of life according to the MOS-SF-36 questionnaire, and intensity of pain syndrome according to the visual analog scale (VAS) were assessed in both groups.Results. Prior to the treatment start in the both groups, patients had biomechanical disorders of the neck region (structural component — in 50 % of the participants in the main group and 40 % of the control group), thoracic region (structural component — in 55 and 60 %, respectively), lumbar region (structural component — 95 and 55 %, and the visceral component — 45 and 20 %), the pelvic region (structural component — 100 and 95 %). In the main group, regional biomechanical disorders of the pelvic region were also detected, the visceral component — in 50 % of the participants. After the treatment, the patients of both groups had no regional biomechanical disorders of the thoracic region (structural component), the lumbar region (visceral component), and the pelvic region (visceral component). In the main group, in addition, there was a statistically significant (p<0,05) positive dynamics in relation to dysfunctions of the neck region (structural component), lumbar region (structural component), pelvic region (structural component). The groups began to differ significantly (p<0,05) in relation to the following regional disorders: lumbar region (structural component) and pelvic region (structural component). At the study start, the participants in the both groups were characterized by low quality of life, assessed by SF-36, and severe pain by VAS. After the treatment in both groups, there were statistically significant (p<0,05) positive dynamics in all of the above indicators: the pain syndrome severity decreased, and the life quality indicators increased; and in the main group the results were statistically significantly (p<0,05) more pronounced.Conclusion. Based on the obtained results, it is possible to recommend the inclusion of osteopathic correction in the complex therapy of pelvic pain syndrome in women at the late postpartum period. But also it is recommended to continue the study with the involvement of a larger number of participants.

The Effect Of Giving Rose Aromatherapy On Labor Pain

Labor pain as a physiological process occurs due to contraction of the myometrium. Labor pain has a different intensity in each individual. If not handled properly, labor pain and anxiety experienced by the mother can cause trauma. One of the non-pharmacological treatments that can be done is rose aromatherapy. The objective to determine the effect of giving rose aromatherapy to labor pain in the first stage at the Ciputat Fruit Heart Hospital, South Tangerang, Banten Province in 2022. This type of research is a quasi-experimental with a pretest and posttest one group design. The study was conducted at Ciputat Fruits Hospital, South Tangerang, from July to early August 2022. The population of all physiological birth mothers at Ciputat Fruits Hospital, South Tangerang, Banten Province in July 2022, the total sample was 30 people. The sampling technique is purposive sampling. Data were analyzed using univariate and bivariate with the Wilcoxon test. Data were processed using a computer with the SPSS program. Before being given rose aromatherapy, it was found that the intensity of labor pain in the first stage of labor, namely only 1 person (3.3%) experienced mild pain. Meanwhile, after being given rose aromatherapy, it was found that the intensity of labor pain in the first stage of labor, namely those experiencing mild pain, increased to 9 people (30.0%). Statistical test results of the effect of giving rose aromatherapy to labor pain in the first stage at the Ciputat Fruit Heart Hospital, South Tangerang, Banten Province in 2022 (p value 0.000). Aromatherapy of roses is good in helping to reduce the intensity of labor pain during the first active phase. It is hoped that health workers can implement this intervention in maternity clinics to help mothers reduce the intensity of labor pain.

Management of term breech presentation

Key content While most breech babies are delivered by caesarean section, a small number are born vaginally. Detailed counselling and an accoucher skilled in vaginal breech birth (VBB) are essential for offering the modality. External cephalic version (ECV) is safe, acceptable to most women, has few contraindications and increases vaginal birth rates. Undiagnosed term breech presentation can largely be prevented by routine third‐trimester ultrasound. Research is needed to evaluate the efficacy of VBB simulation training in clinical practice. Learning objectives To understand the evidence base around breech presentation at term, including ECV, VBB, caesarean section and adjunctive methods of cephalic version. To understand the prerequisites for, and contraindications to, VBB. To understand the principles of physiological breech birth. To appreciate the variation in management of term breech presentation internationally and understand the impact of various publications. Ethical issues With falling rates of VBB, and many units now unable to offer the modality, questions surround the appropriateness of national guidance continuing to present vaginal breech as routine. Conversations around breech birth isolate discussion of risk to the fetus. Maternal risk, which may extend beyond the current pregnancy, cannot be overlooked.

Patterns in Second Stage Labor Care Practices Associated With Genital Tract Injury and Postpartum Hemorrhage During Physiologic Birth: A Latent Mixture Model Analysis

INTRODUCTIONGenital tract injury during childbirth contributes to short and long-term problems, including postpartum hemorrhage, incontinence, and pelvic organ prolapse. The purpose of this study was to examine which sets of second stage management techniques employed by midwives attending births in the community setting are associated with genital tract injury and subsequent postpartum hemorrhage.METHODSData from primiparous individuals within the Midwives Alliance of North America (MANA) Stats 2.0 (2004–2009) database were used for this analysis. Latent mixture modeling identified classes (groups) within the sample that are most similar based on 11 different characteristics of second stage management as noted by midwives in their birth notes, including hands-on management techniques during birth, maternal positioning at birth, and water birth.RESULTSThree classes of second stage management techniques best fit this complex dataset. The patterns of techniques used by midwives were only marginally associated with better or worse genital tract outcomes independent of other factors. Two covariables, however, advanced maternal age (OR1.60, 95% CI 1.09–2.34) and births with low fetal heart rate during second stage (OR2.82, 95% CI 1.93–4.10)—were associated with severe genital tract injury. Postpartum hemorrhage was more likely for the two classes where midwives used more hands-on management during second stage, even when considering presence of genital tract injury (OR1.33, 95% CI 1.09–1.63). This study highlights the complex second stage circumstances that interact with management techniques, which together shape or contribute to both genital tissue and hemorrhage outcomes.

Prenatal care in US birth centers: Midwives' perceptions of contributors to birthing People's confidence in physiologic birth.

The purpose of this study was to describe US freestanding birth center models of prenatal care and to examine how the components of this care contribute to birthing people's confidence in their ability to have a physiologic birth. This was a qualitative descriptive study utilizing semi-structured interviews with birth center midwives. Data were analyzed using thematic analysis, constant comparative method and consensus coding to ensure rigor. Midwives from six urban and rural freestanding birth centers in a Midwestern US state were interviewed. Twelve birth center midwives participated. Six themes emerged: the birth center physical space and organization of care, dimensions of midwifery care within the birth center, continuity of care and seamless service, the empowered birthing person, physiologic birth as normative, and the hospital paradigm and US cultures of birth. We identified significant components of birth center models of prenatal care that midwives believe enhance birthing people's confidence for physiologic childbirth. These components may be considered for application to other settings and may improve perinatal care and outcomes.

Factors that Promote a Positive Childbearing Experience: A Qualitative Study.

Experiences of pregnancy and birth are important and have long-term impacts on the well-being of women and their families. Perinatal services should aim for care that promotes a positive childbearing experience, as well as optimizing health outcomes for the woman and newborn. This study aimed to understand the health system factors that promote a positive childbearing experience. Women who had a positive experience and had given birth in Australia in the previous 12 months were recruited for individual semistructured interviews. The interview guide focused on health system factors that participants credited with contributing to their positive experience of perinatal care. Interviews were conducted until data saturation was reached. Qualitative data were transcribed verbatim and analyzed using inductive thematic analysis. Data from 36 interviews were thematically analyzed, and 4 major themes were generated: health care provider attributes, health system attributes, communication and decision-making, and experience of care. The salient factors that promoted positive experiences included care that was respectful and individualized with effective communication, access to midwifery continuity of care models, and good integration between services. Competent and professional health care providers who facilitated shared decision-making were also essential. Although women often sought out care that promoted physiologic birth, they emphasized that the way they were cared for was more important than fulfilling specific birth aspirations. Quality maternity care has the capacity to support a woman's confidence in her own abilities and promote a positive, and sometimes transformative, childbearing experience.

O6 - “A way to bring my labour back to normal”: An immersive sensory experience during childbirth

The setting in which a woman labours, influences her birth experience. Ninety-seven percent of women in Australia give birth in conventional hospital birth suites, where medical safety often overshadows attention to psychological needs. Sensory information from the external environment can help decrease pain, fear, and stress through oxytocin-mediated neurohormonal processes. No place is this more urgently needed than in the hospital birth suite. This proof-of-concept study aimed to explore women’s and midwives' experiences of using an immersive sensory experience (ISE) during labour. We installed a screen projecting nature-themed films and conducted a thematic analysis of interviews with 32 women who laboured in this setting. All the women received continuity of midwifery care from caseload midwives. Four in five women had medical or obstetric risk factors, and two-thirds had their labour induced. Semi-structured interviews were conducted with nine midwives who worked in caseload and had cared for women who used the ISE. Three themes emerged from interviews with women: 1) Serenity and calm; 2) Redirection of attention; and 3) Immersive feeling. Three themes emerged from interviews with midwives: 1) The ISE aligned with midwives’ identity and birthing philosophies; 2) The ISE inspired care practices that supported physiology; and 3) The ISE improved midwives’ experience of providing care. The findings are consistent with research demonstrating the effects of physical attributes of the environment on caregiver behaviour and women’s experiences. Overwhelmingly these finding demonstrate that midwives, women, and their partners enjoyed the immersive experience and how it positively improved the birth setting to optimise physiological labour and birth. No safety concerns were identified, and midwives reported positive feedback from colleagues.

Beckenendlage am Termin

The breech position is a variant of presentation, which occurs in ca. 3–6% of pregnancies at term. After prenatal counseling and shared decision-making, first an external cephalic version and thereafter a cesarean section (planned or at onset of labor) or a vaginal delivery from the breech position can be offered. At present a vaginal delivery is only possible and safe in specialized and designated departments. The quality of care is dependent on various factors: selection of a suitable candidate, wide experience of the involved obstetrician and midwives and written guidelines. An upright delivery position is advantageous in breech presentation and leads to a physiological spontaneous birth in approximately half of the cases. This article focuses on the management of breech presetation in uncomplicated pregnancy at term in the presence of a breech position.

Beautifying Birth: A Simple Tool to Promote Physiology

As a senior midwife working on an obstetric-led unit, I was concerned with the rising levels of intervention we were witnessing and wanted to investigate ways to support midwives and birthing people to have empowering experiences and achieve better outcomes. The idea of creating ‘beautifying birth’ boxes was taken from a post on Twitter by Emma Thorns,1 which illustrated how to transform clinical, high-risk areas into dimly lit, homelike spaces using items such as battery-operated tea lights and fairy lights to aid and support physiological labour and birth. Staff and birthing people have benefited from the boxes, with feedback being extremely positive since they have been introduced, and the boxes commonplace on the unit being utilised daily.

P20 - The future of Childbirth Education in maternity care; Raising the bar and changing the consumer experience of antenatal education when preparing for parenthood during a global pandemic

There is no doubt at the centre of midwifery exists the experience of the birthing woman, her connection to her midwife and the preparation she makes with her partner for parenthood. Integral to the preparation for parenthood lies childbirth education. In 2019, this question was posed by researchers Kate Levett and Hannah Dahlen. Are we doing enough to prepare women for childbirth? The answer, simply across Australia we are not. Antenatal education programmes within hospitals were said to be time poor and information heavy with scheduling fixed due to staffing pressures. The effects of teaching a broad curriculum in limited sessions were listed as- • leaving consumers of maternity services feeling unprepared • fearful • inadequate in their preparation for physiological childbirth. At St John of God Midland Public Hospital, the consumer experience has shaped our collaboration commenced in October 2021. Working together, consumers at our hospital have access to: • a standardised programme of childbirth education created and delivered by a certified childbirth educator • evidence based education during both low and high risk models of care • the benefits of clinical and non-clinical educational sessions delivered by Lesley and Elissa • an opportunity to gain knowledge and develop skill based comfort measures for labour and birth support • Next Birth After Caesarean specialist parent education during early and late pregnancy Our Presentation. A qualitative review of our innovative collaboration to answer these questions; • What has been the consumer experience of this new model of delivering parent education? • During the pandemic when staff shortages are at an all time high, what impacts have been noticed when staffing a busy public maternity service? • Are we preparing our birthing families to cope with physiological labour and birth? • Bringing outside expertise into maternity departments, could this be the future of delivering childbirth education in Australia?

W1 - Protecting the Pelvic Floor During Pregnancy, Birth and Postpartum: Putting Physiology in Practice

to gain an understanding of the prevention, symptoms, diagnosis and treatment of core and pelvic floor disorders throughout pregnancy, labour, birth and postpartum. this interactive workshop will enable you to gain a deeper understanding of the physiology of the core and pelvic floor during pregnancy, birth and postpartum. You will learn practical techniques to assist women in protecting their core and pelvic floor during these stages, including how best to support physiological birth and what we can do when interventions occur. We will also cover techniques and realities for postpartum healing and evidence-based advice to managing existing conditions. Up to 75% of women will experience a prolapse in their lifetime. 1 in 3 will experience urine incontinence and 1 in 10 anal incontinence. Around 60% of women experience diastasis recti. Add in pelvic girdle pain, a hypertonic pelvic floor, perineal and vulva trauma, vaginismus, vulva varicosities, anal fissures and haemorrhoids and most women, at some point, will describe their body as feeling broken. Midwives play a crucial role in assisting women in the prevention and treatment of these core and pelvic floor conditions. Australian guidelines and clinical standards advise that pregnant and postpartum people should be doing pelvic floor muscle training (PFMT). This however, is not just as simple as doing Kegels while waiting at traffic lights. In order to provide best care, midwives need a deeper understanding of the physiology of the core and pelvic floor in pregnancy, birth and postpartum. this workshop will enable midwives to confidently care for and advise people on how to protect their core and pelvic floor and manage related issues.

Association between high levels of comorbid anxiety and depressive symptoms and decreased likelihood of birth without intervention: A longitudinal prospective cohort study.

To assess the association between trajectories of comorbid anxiety and depressive (CAD) symptoms assessed in each pregnancy trimester and physiological birth. Large longitudinal prospective cohort study with recruitment between January 2013 and September 2014. Primary care, in the Netherlands. Dutch-speaking pregnant women with gestational age at birth ≥37 weeks, and without multiple pregnancy, severe psychiatric disorder or chronic disease history. Pregnancy-specific anxiety and depressive symptoms were measured prospectively in each trimester of pregnancy using the negative affect subscale of the Tilburg Pregnancy Distress Scale and Edinburgh (Postnatal) Depression Scale. Data on physiological birth were obtained from obstetric records. Multivariate growth mixture modelling was performed in MPLUS to determine longitudinal trajectories of CAD symptoms. Multiple logistic regression analysis was used to examine the association between trajectories and physiological birth. Trajectories of CAD symptoms and physiological birth. Seven trajectories (classes) of CAD symptoms were identified in 1682 women and subsequently merged into three groups: group 1-persistently low levels of symptoms (reference class 1; 79.0%), group 2-intermittently high levels of symptoms (classes 3, 6 and 7; 11.2%), and group 3-persistently high levels of symptoms (classes 2, 4 and 5; 9.8%). Persistently high levels of CAD symptoms (group 3) were associated with a lower likelihood of physiological birth (odds ratio 0.67, 95% confidence interval 0.47-0.95, P=0.027) compared with the reference group (persistently low levels of symptoms), after adjusting for confounders. This study is the first showing evidence that persistently high CAD levels, assessed in each pregnancy trimester, are associated with a lower likelihood of physiological birth.

Examination of the psychometric properties of the Turkish version of the preparation for labor and birth (P-LAB) instrument

ObjectiveIt is known that a positive birth experience depends on the mother's belief and confidence in her ability to successfully achieve the birth. Therefore, it is important to determine women's self-confidence and readiness for childbirth. The purpose of this study is to determine the Turkish validity and reliability and adaptation to the Turkish culture of the Preparation for Labor and Birth instrument that was developed to measure the belief and confidence of pregnant women in their ability to achieve physiological birth. DesignThis is a descriptive, cross-sectional, and methodological study. It was conducted from January 30 to June 30, 2021, with 235 healthy pregnant women who are in their third trimester. Data are collected with a sociodemographic form and the Preparation for Labor and Birth instrument (P-LAB). FindingsThe Preparation for Labor and Birth instrument consists of 22 items and four subdimensions. The scale explains 69.10% of the total variance. In explanatory and confirmatory factor analysis, factor coefficients are found above 0.30, and most of the fit indices are above 0.90. Cronbach's alpha value is above 0.70 for all scales and subscales. Key conclusionsIt is determined that the Preparation for Labor and Birth instrument is valid and reliable for the Turkish sample.

Midwives’ experience of personal/professional risk when providing continuity of care to women who decline recommendations: A meta-synthesis of qualitative studies

ProblemWomen’s autonomous choices in pursuit of physiological childbirth are sometimes limited by the midwife’s willingness to support those choices, particularly when those choices are contrary to recommendations or outside of guidelines. BackgroundWomen’s reasons for making such choices have received some research attention, however there is a paucity of research examining this phenomenon from the perspective of caseloading midwives’ and their perception of personal/professional risk in such situations. AimTo synthesise qualitative research which includes the voices of midwives working in a continuity of carer model who perceive any kind of risk to themselves when caring for women who decline current established recommendations. MethodsSystematic literature search and meta-synthesis were carried out following a pre-determined search strategy. The search was executed in April 2021 and updated in July 2021. Studies were assessed for quality using JBI Critical Appraisal Checklist for Qualitative Research. Data extraction was assisted by JBI QARI Data Extraction Tool for Qualitative Research. GRADE-CERQual was applied to the findings. FindingsEight studies qualified for inclusion. Five main themes were synthesised as third order constructs and were incorporated into a line of argument: Women’s rights to bodily autonomy and choice in childbearing are violated, and their ability to access safe midwifery care in pursuit of physiological birth is restricted, when midwives practise within a maternity system which is adversarial towards midwives who provide the care which women require. Midwives who provide such care place themselves at risk of damaged reputation, collegial conflict, intimidating disciplinary processes, tensions of ‘being torn’, and a heavy psychological load. Despite these personal and professional risks, midwives who provide this care do so because it is the ethical and moral thing to do, because they recognise that women need them to, because it can be very rewarding, and because they are able to. ConclusionMaternity systems and colleagues can be key risk factors for caseloading midwives who facilitate women’s right to decline recommendations. These identified risks can make it unsustainable for midwives to continue providing woman-centred care and contribute to workforce attrition, reducing options/choices for women which paradoxically increases risk to women and babies.

Effects of Labor Support Education on Nursing Knowledge, Confidence, and Cesarean Rates

Despite physical, psychological, and financial consequences, nulliparous, term, singleton, vertex (NTSV) cesareans have continued to rise. A goal of Healthy People 2020 was to reduce NTSV cesarean rates to 24.7%. In 2020, Carilion New River Valley Medical Center (CNRVMC) reported a monthly NTSV cesarean rate of 50%, with a yearly mean of 30.4%. Research suggests that registered nurses can significantly contribute to the reduction of cesareans through evidence-based labor support (EBLS). To reach the Healthy People 2020 goal at CNRVMC, an EBLS education program was implemented to reinforce nurse-led interventions that support normal physiological birth.