Midwifery
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Case Reports Randomized Controlled Trial Clinical Trial
Case studies of three pregnant smokers and their use of nicotine replacement therapy.
To examine the barriers encountered by pregnant women who attempt to stop smoking by highlighting three women who used nicotine patches. ⋯ Although health providers intuitively regard pregnancy as an appropriate time for women to stop smoking, the stressors during pregnancy seem to militate against cessation. This study does not indicate that use of NRT will provide an easier solution. It may be more fruitful to institute a concerted lifestyle approach with both the woman and her partner (or significant household members), and continue this support and education postnatally if cessation has not been achieved. Health professionals should also support better-targeted public health campaigns and tobacco-control initiatives generally, because, undoubtedly, the social environment is a major determinant of initiation and continuation of smoking.
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Randomized Controlled Trial Clinical Trial
A randomised controlled trial in the north of England examining the effects of skin-to-skin care on breast feeding.
to examine the effect of early skin-to-skin contact between mothers and their healthy full-term babies on initiation and duration of breast feeding. ⋯ the difference between the groups in the success rate for the first breast feed and rates at 4 months was not statistically significant. However, mothers who had skin-to-skin contact enjoyed the experience, and most reported that they would choose to have skin-to skin care in the future. In this, the largest trial to date, previous concerns about baby-body temperature after skin-to-skin care were dispelled.
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Randomized Controlled Trial Clinical Trial
A prospective randomised trial on the effect of position in the passive second stage of labour on birth outcome in nulliparous women using epidural analgesia.
To determine whether the rate of instrumental birth in nulliparous women using epidural analgesia is affected by maternal position in the passive second stage of labour. ⋯ Women randomised to the lateral position had a better chance of a spontaneous vaginal birth than those randomised to the supported sitting position. Position of the babies head at full dilation had an additional effect on mode of birth. These effects are not conclusively generalizable. RECOMMENDATIONS FOR PRACTICE: The lateral position is likely to be at best beneficial, and at the worst no less harmful than the sitting position for most women and their babies who meet the criteria set for this study. Conclusive evidence for or against the technique should be established using larger trials.