Midwifery
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Randomized Controlled Trial Multicenter Study
Are all skilled birth attendants created equal? A cluster randomised controlled study of non-physician based obstetric care in primary health care clinics in Mexico.
the great majority of births in Mexico are attended by physicians. Non-physician health professionals have never been evaluated or compared to the medical model of obstetric care. This study evaluates the relative strengths of adding an obstetric nurse or professional midwife to the physician based team in rural clinics. ⋯ Mexican National Institute for Women, Mexican National Center for Gender Equity and Reproductive Health, MacArthur Foundation, Bill and Melinda Gates Foundation.
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Randomized Controlled Trial
Comparison of a single vs. a four intradermal sterile water injection for relief of lower back pain for women in labour: a randomised controlled trial.
sterile water injections are a simple, safe, effective, non-pharmacological technique for relieving back pain in labour, however the number of injections required to achieve optimal analgesia is unknown. The objective of this trial was to evaluate the degree and duration of analgesia provided by a single injection of sterile water, compared to four injections. ⋯ the four injection technique was associated with increased level of analgesia at 30 mins post-intervention compared to the single injection, but also a greater degree of injection pain.
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Randomized Controlled Trial
A randomised clinical trial of the effect of low-level laser therapy for perineal pain and healing after episiotomy: a pilot study.
to evaluate the effects of low-level laser therapy for perineal pain and healing after episiotomy. ⋯ this pilot study showed that LLLT did not accelerate episiotomy healing. Although there was a reduction in perineal pain mean scores in the experimental group, we cannot conclude that the laser relieved perineal pain. This study led to the suggestion of a new research proposal involving another irradiation protocol to evaluate LLLT's effect on perineal pain relief.
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Randomized Controlled Trial
Effects of birth ball exercise on pain and self-efficacy during childbirth: a randomised controlled trial in Taiwan.
To examine the effectiveness of a birth ball exercise programme during childbirth by measuring childbirth self-efficacy and childbirth pain. In addition, it tested the mediating effects of childbirth self-efficacy on the relationship between the birth ball exercise programme and childbirth pain. ⋯ Clinical implementation of the birth ball exercise programme could be an effective adjunctive tool to improve childbirth self-efficacy and reduce pain among women in labour. On the basis of our mediating model, the results further suggest that confidence is greater after prenatal preparation powerfully related to decreased pain perception and decreased medication/analgesia use during labour.
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Randomized Controlled Trial
Hi-TENS combined with PCA-morphine as post caesarean pain relief.
to examine effectiveness and overall opiate consumption between high-sensory transcutaneous electrical nerve stimulation (Hi-TENS) combined with patient-controlled analgesia with morphine and patient-controlled analgesia with morphine alone following elective (e.g. scheduled) caesarean birth. ⋯ pain relief from a combination of Hi-TENS and patient-controlled analgesia with morphine was as effective as patient-controlled analgesia with morphine alone, produced less sedation and reduced morphine use by approximately 50%. Women undergoing a caesarean section should be given the opportunity to make an informed choice about post operative pain relief before surgery. A presumed benefit of this treatment combination is that the mother is more alert and better able to interact with her newborn during the first hours after birth without drowsiness due to large doses of opiates.