Effects of Midwifery Care on Mode of Delivery, Duration of Labor and Postpartum Hemorrhage of Elderly Parturients
Background: We aimed to explore the influence of midwifery care on the mode of delivery (MOD), duration of labor and postpartum hemorrhage (PPH) of elderly parturients.
Methods: A total of 165 elderly parturients admitted to Tongde Hospital of Zhejiang Province, China from May 2018 to Aug 2019 were allocated into a study group (n=85, midwifery care) and a control group (n=80, conventional nursing care). Visual analogue scale (VAS) was employed to estimate the pain of parturients, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were employed to evaluate the anxiety and depression status. The satisfaction of patients on nursing care was scored by a self-made satisfaction questionnaire.
Results: The parturients in the study group presented higher spontaneous vaginal delivery (SVD) rate (P < 0.05), and had shortened duration of first and second stages of labor and total duration of labor (P < 0.05). The incidence of both PPH and neonatal asphyxia in the study group was lower than that in the control group (both P < 0.05). The VAS, SAS and SDS scores in the study group were significantly lower than those in the control group (P < 0.05), and the patients’ satisfaction in the study group was significantly higher (P < 0.05).
Conclusion: Midwifery care is effective for the delivery of elderly parturients, which significantly improves VSD rate, shortens duration of labor, reduces incidence of PPH and neonatal asphyxia, as well as relives labor pain, anxiety and depression, and increases satisfaction of parturients.
2. Kahveci B, Melekoglu R, Evruke IC, et al (2018). The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. BMC Pregnancy Childbirth, 18(1): 343.
3. Sheinis M, Carpe N, Gold S, et al (2018). Ig-norance is bliss: women's knowledge re-garding age-related pregnancy risks. J Ob-stet Gynaecol, 38(3): 344‐351.
4. Bellieni C (2016). The Best Age for Pregnan-cy and Undue Pressures. J Family Reprod Health, 10(3): 104‐107.
5. Niessen K, Werner-Bierwisch T, Metzing S, et al (2017). [Motherhood at the Age of 35 and Over: The Risk of Advanced Ma-ternal Age as Perceived by Women - a Literature Study]. Z Geburtshilfe Neonatol, 221(3): 111‐121.
6. Mengistu MD, Kuma T (2020). Feto-maternal outcomes of hypertensive dis-orders of pregnancy in Yekatit-12 Teach-ing Hospital, Addis Ababa: a retrospec-tive study. BMC Cardiovasc Disord, 20(1): 173.
7. Dennis CL, Vigod S (2019). Expanding midwifery's role to improve perinatal mental healthcare access. Evid Based Nurs, 22(3): 72.
8. Sauer MV (2015). Reproduction at an ad-vanced maternal age and maternal health. Fertil Steril, 103(5): 1136‐1143.
9. Radoń-Pokracka M, Adrianowicz B, Płonka M, et al (2019). Evaluation of Pregnancy Outcomes at Advanced Maternal Age. Open Access Maced J Med Sci, 7(12): 1951‐1956.
10. Hollins Martin CJ, MacArthur J, Martin CR, et al (2019). Midwives' views of changing to a Continuity of Midwifery Care (CMC) model in Scotland: A baseline sur-vey. Women Birth, S1871-5192(19)30375-0.
11. McInnes RJ, Aitken-Arbuckle A, Lake S, et al (2020). Implementing continuity of mid-wife carer - just a friendly face? A realist evaluation. BMC Health Serv Res 20(1): 304.
12. Rayment-Jones H, Silverio SA, Harris J, et al (2020). Project 20: Midwives' insight into continuity of care models for women with social risk factors: what works, for whom, in what circumstances, and how. Midwifery, 84: 102654.
13. Edmonds JK, Ivanof J, Kafulafula U (2020). Midwife Led Units: Transforming Ma-ternity Care Globally. Ann Glob Health, 86(1): 44.
14. Viveiros CJ, Darling EK (2018). Barriers and facilitators of accessing perinatal mental health services: The perspectives of women receiving continuity of care mid-wifery. Midwifery, 65: 8‐15.
15. Devane D, Barrett N, Gallen A, et al (2019). Identifying and prioritising midwifery care process metrics and indicators: a Delphi survey and stakeholder consensus process. BMC Pregnancy Childbirth, 19(1): 198.
16. Aune I, Holsether OV, Kristensen AMT (2018). Midwifery care based on a precau-tionary approach: Promoting normal births in maternity wards: The thoughts and experiences of midwives. Sex Reprod Healthc, 16: 132‐137.
17. Kawakita T, Mokhtari N, Huang JC, et al (2019). Evaluation of Risk-Assessment Tools for Severe Postpartum Hemor-rhage in Women Undergoing Cesarean Delivery. Obstet Gynecol, 134(6): 1308‐1316.
18. Heller GZ, Manuguerra M, Chow R (2016). How to analyze the Visual Analogue Scale: Myths, truths and clinical relevance. Scand J Pain, 13: 67‐75.
19. Kanmaz AG, İnan AH, Beyan E, et al (2019). Effect of advanced maternal age on pregnancy outcomes: a single-centre data from a tertiary healthcare hospital. J Obstet Gynaecol, 39(8): 1104‐1111.
20. Gao Y, Tang Y, Tong M, et al (2019). Does attendance of a prenatal education course reduce rates of caesarean section on ma-ternal request? A questionnaire study in a tertiary women hospital in Shanghai, China. BMJ Open, 9(6): e029437.
21. Spada E, Chiossi G, Coscia A, et al (2018). Effect of maternal age, height, BMI and ethnicity on birth weight: an Italian multi-center study. J Perinat Med, 46(9): 1016‐1021.
22. Goyet S, Broch-Alvarez V, Becker C (2019). Quality improvement in maternal and newborn healthcare: lessons from pro-grammes supported by the German de-velopment organisation in Africa and Asia. BMJ Glob Health, 4(5): e001562.
23. Pinar G, Avsar F, Aslantekin F (2018). Evalu-ation of the Impact of Childbirth Educa-tion Classes in Turkey on Adaptation to Pregnancy Process, Concerns About Birth, Rate of Vaginal Birth, and Adapta-tion to Maternity: A Case-Control Study. Clin Nurs Res, 27(3): 315‐342.
24. Shi Y, Jiang Y, Zeng Q, et al (2016). Influ-encing factors associated with the mode of birth among childbearing women in Hunan Province: a cross-sectional study in China. BMC Pregnancy Childbirth, 16: 108.
25. Smith CA, Levett KM, Collins CT, et al (2018). Relaxation techniques for pain management in labour. Cochrane Database Syst Rev, 2018(3): CD009514.
26. Bayrampour H, Hapsari AP, Pavlovic J (2018). Barriers to addressing perinatal mental health issues in midwifery set-tings. Midwifery, 59: 47‐58.
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