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首页> 外文期刊>Australian and New Zealand Journal of Obstetrics and Gynecology >Can antenatal education influence how women push in labour?
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Can antenatal education influence how women push in labour?

机译：产前教育会影响妇女的分娩方式吗？

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BACKGROUND: Antenatal education on the physiology of second stage of labour and effective pushing has not been studied in the literature. Anecdotal observation seems to indicate that some nulliparous women are (at least initially) unable to push effectively. A large proportion seem to reflexly contract the levator ani muscle when asked to push which may have the effect of slowing the progress of labour. AIMS: To test the effectiveness of structured antenatal education for pushing in the second stage of labour versus normal care and its impact on delivery outcome. METHODS: One hundred nulliparous women between 35 and 37 weeks gestation were randomised. Intervention: Two 15-min structured education sessions, one week apart, utilising observation of the perineum and a vaginal examination to teach correct technique for relaxing the levator ani muscle and effective pushing. RESULTS: In both groups, 31 of 50 women (62%) delivered vaginally. Instrumental delivery and caesarean section rates did not differ between the two groups (P = 0.78, relative risk = 1). The mean duration of active second stage for the control group was 53.96 min compared with 57.26 min for the intervention group. This difference of 3.3 min was not statistically significant (P = 0.56). Knowledge of women in the intervention group was increased and the majority of women found the educational sessions helpful. CONCLUSION: Antenatal teaching to ensure effective maternal pushing in labour did not result in altered obstetric outcomes relative to the control group. However, there was a measurable qualitative effect from the intervention in that women clearly felt the education sessions to be helpful.
机译：背景：关于第二胎分娩生理和有效推拿的产前教育尚未在文献中进行研究。轶事观察似乎表明，一些未生育的妇女（至少在一开始）无法有效推动。当被要求推动时，很大一部分似乎反射了肛提肌收缩，这可能会减慢分娩的进程。目的：测试结构化产前教育在第二阶段分娩与正常护理之间进行推销的有效性及其对分娩结果的影响。方法：将妊娠35至37周的100例未生育妇女随机分组。干预：两个15分钟的结构化教育课程，相距一个星期，利用会阴的观察和阴道检查来教授放松肛提肌和有效推挤的正确技术。结果：两组中，有50名女性中有31名（62％）阴道分娩。两组的工具分娩率和剖腹产率无差异（P = 0.78，相对风险= 1）。对照组活动第二阶段的平均持续时间为53.96分钟，而干预组为57.26分钟。 3.3分钟的差异无统计学意义（P = 0.56）。干预组中妇女的知识有所增加，大多数妇女认为教育课程很有帮助。结论：与对照组相比，产前教学以确保有效的产妇分娩不会导致产科结果改变。但是，干预措施产生了可测量的定性效果，因为妇女显然认为教育课程是有帮助的。

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