Comparison of Spontaneous Pushing and Directed Pushing During the Second Stage of Labor Among Chinese Women Without Epidural Analgesia : Protocol for a Noninferior Feasibility Study

©Jiasi Yao, Heike Roth, Debra Anderson, Hong Lu, Huijuan Rong, Kathleen Baird. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 26.03.2024..

BACKGROUND: Maternal pushing during the second stage of labor could influence labor progress and maternal-neonatal outcomes. Although the image of health care providers directing the laboring women to push during the second stage of labor could be commonly observed globally, this practice is not sufficiently researched and is questioned regarding its effectiveness and outcomes on the mother and baby. Meanwhile, a strategy referred to as "spontaneous pushing," which supports women to push by following their bodily urges, has been evaluated in several trials. However, in China, spontaneous pushing is not common practice. Notwithstanding the evaluation of spontaneous pushing, there is a lack of high-quality evidence to support either strategies of directed pushing or spontaneous pushing.

OBJECTIVE: This study aims to test the feasibility of a future randomized controlled trial to compare the effects of spontaneous pushing and directed pushing during the second stage of labor for maternal and neonatal outcomes in China.

METHODS: A nonrandomized, single-group, noninferiority feasibility study will be conducted in a public hospital in Hebei Province, China. In total, 105 women meeting the selection criteria will be recruited to receive the intervention (spontaneous pushing), while 105 sets of medical notes from women who received routine care (directed pushing) will be identified and reviewed to compare outcomes for both cohorts. A mixed methods approach will be used to assess primary outcomes (feasibility and acceptability) and secondary outcomes (effectiveness).

RESULTS: Data collection took place between May and October 2023. A total of 110 women were invited to participate in the intervention of spontaneous pushing. Midwives' interviews were conducted and will be transcribed for analysis in March 2024. The data analysis is planned to be completed by May 2024.

CONCLUSIONS: This feasibility study will provide important information by conducting a full-scale clinical trial in the future as well as the potential facilitators and barriers of it. A future randomized controlled trial is likely to have considerable policy and funding impacts regarding pushing management during the second stage of labor and improvement in women's childbirth experience.

TRIAL REGISTRATION: Chinese Clinical Trial Register ChiCTR2300071178; https://tinyurl.com/mudtnbft.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55701.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:13

Enthalten in:

JMIR research protocols - 13(2024) vom: 26. März, Seite e55701

Sprache:

Englisch

Beteiligte Personen:

Yao, Jiasi [VerfasserIn]
Roth, Heike [VerfasserIn]
Anderson, Debra [VerfasserIn]
Lu, Hong [VerfasserIn]
Rong, Huijuan [VerfasserIn]
Baird, Kathleen [VerfasserIn]

Links:

Volltext

Themen:

Birth
Child
Childbirth
China
Chinese
Cohort
Delivery
Directed pushing
Effectiveness
Feasibility study
Healthcare
Journal Article
Labor
Labour stage, labour
Labouring women
Maternal
Maternal-neonatal outcomes
Midwife
Midwifery
Midwives
Obstetric
Obstetrics
Protocol
Second
Spontaneous pushing
Women

Anmerkungen:

Date Revised 25.04.2024

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.2196/55701

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370198867