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As VacE
xt is so common, we midwives need to recognize the necessity for good
preparation and good follow-up. Sometimes we think VE is great, at least it is
not a C/S. Looks limke we need to try all our means to avoid it. Standing up,
upright kneeling on bed should be options tried before a VacExt is suggested. Traumatic
experience with vacuum extraction--influence of personal preparation,
physiology, and treatment during labor - Journal of Perinatal
Medicine , vol 33, no 5, 2005, pp 373-378 Uotila JT; Taurio K;
Salmelin R; et al - (2005) OBJECTIVE: To assess pre-labor attitudes and post-labor
experiences of the use of vacuum extraction during delivery. To seek
associations between traumatic labor experience and personal preparation, physiology
of labor and treatment during labor. METHODS: A total of 205 women filled in a
questionnaire within five days of vacuum extraction delivery. The questionnaire
was designed to distinguish the group of women having experienced their labor
as traumatic from those not having such an experience. The association between
explanatory variables grouped as background factors, physiological factors of
labor and treatment-related factors in relation to traumatic experience status
was studied by bivariate analysis by the chi-square test or Student's t-test.
Logistic regression analysis was carried out to examine simultaneous effects of
factors. In the first phase, each of the previously chosen groups was analyzed
separately, and in the second, all risk factors thus emerging as significant
were entered into the final model. RESULTS: Forty-two women (20%) regarded
their childbirth experience as traumatic. Of the background factors,
insufficient pre-labor training and a pre-labor desire for extra strong pain
relief during the coming labor were significantly more common in the traumatic
birth group. Of the physiological factors of labor, unsatisfactory pain relief
and a difficult third stage of labor were associated with a traumatic birth
experience. The treatment-related factors showed mutual correlation and were
strongly associated with birth experience. After logistic regression analysis
only four independent risk factors emerged as significant: insufficient support
immediately after delivery, the experience of being poorly listened to during
labor, insufficient doctor's support during the first stage of labor, and
pre-labor training classes considered insufficient. CONCLUSIONS:
Treatment-related factors were the most powerful predictors of an adverse birth
experience after vacuum extraction delivery, exceeding those related to labor
physiology. Thus, the role of
treatment and care before, during and after vacuum extraction is emphasized. ( |
