NDLI: Variability of clinical practice in the care of the second stage of labor among midwives in Spain

Content Provider	Springer Nature : BioMed Central
Author	Díaz, Estíbaliz Laderas Rodriguez-Almagro, Julián Martinez-Galiano, Juan Miguel Rodríguez, Rafael Picón Hernández-Martínez, Antonio
Abstract	Background There are recommendations based on scientific evidence on care in the second stage of labor, but it is not known to what degree the professionals comply with these recommendations. Objective The aim of this study is to examine the variability in clinical practices among midwives during the second stage of labor, including positions, mobility, practices, and the maximum time allowed before initiating active pushing, and to assess their adherence to clinical practice guidelines. Methods A cross-sectional observational study. A self-designed questionnaire was developed and distributed online through scientific societies. The main variables studied were professional and work environment characteristics, maternal positions and mobility, practices during this stage, maximum time to start active pushing and duration of the second stage of labor. Descriptive statistics were calculated using SPSS 24.0. Results Regarding the woman’s position during childbirth, 80.3% (245) of midwives frequently or always allow the woman to choose her birthing position. Furthermore, 44.6% (136) of professionals prefer using side-lying positions for the mother. Regarding drinking fluids during childbirth, 51.1% (156) of midwives allowed the woman to drink the amount of liquids she wanted, whereas 11.1% (34) said that they would allow them to do so however, this was against the protocol of their hospital. When inquiring about the Kristeller maneuver, it was reported to be excessively performed in 35.1% (107) of cases for fetal bradycardia, 33.1% (101) for maternal exhaustion, and 38.4% (117) to avoid instrumental birth. Finally, a great variability was observed in the time criteria used for the initiation of active pushing and the maximum duration of the second stage of labor. Conclusions Certain practices, such as the Kristeller maneuver, are overused among midwives, with great variability in the use of certain procedures, the waiting times to initiate pushing and completion of the second stage of labor. Further training and awareness campaigns are needed for professionals to apply evidence-based care.
Related Links	https://bmcnurs.biomedcentral.com/counter/pdf/10.1186/s12912-024-01863-7.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14726955
DOI	10.1186/s12912-024-01863-7
Journal	BMC Nursing
Issue Number	1
Volume Number	23
Language	English
Publisher	BioMed Central
Publisher Date	2024-03-26
Access Restriction	Open
Subject Keyword	Nursing Nursing Management Nursing Research Variability Midwife Obstetrics Professional practice Second stage labor
Content Type	Text
Resource Type	Article
Subject	Nursing
Journal Impact Factor	3.1/2023
5-Year Journal Impact Factor	3.5/2023

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