MCN. The American journal of maternal child nursing
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MCN Am J Matern Child Nurs · Mar 2010
ReviewOvercoming the challenges: maternal movement and positioning to facilitate labor progress.
The benefits of maternal movement and position changes to facilitate labor progress have been discussed in the literature for decades. Recent routine interventions such as amniotomy, induction, fetal monitoring, and epidural anesthesia, as well as an increase in maternal obesity, have made position changes during labor challenging. The lack of maternal changes in position throughout labor can contribute to dystocia and increase the risk of cesarean births for failure to progress or descend. This article provides a historical review of the research findings related to the effects of maternal positioning on the labor process and uses six physiological principles as a framework to offer suggestions for maternal positioning both before and after epidural anesthesia.
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MCN Am J Matern Child Nurs · Mar 2010
Randomized Controlled TrialDelayed versus immediate pushing in second stage of labor.
Comparison of two different methods for management of second stage of labor: immediate pushing at complete cervical dilation of 10 cm and delayed pushing 90 minutes after complete cervical dilation. ⋯ Delaying pushing for up to 90 minutes after complete cervical dilation resulted in a significant decrease in the time mothers spent pushing without a significant increase in total time in second stage of labor.In clinical practice, healthcare providers sometimes resist delaying the onset of pushing after second stage of labor has begun because of a belief it will increase labor time. This study's finding of a 51% reduction in pushing time when mothers delay pushing for up to 90 minutes, with no significant increase in overall time for second stage of labor, disputes that concern.
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: To examine policies and practices related to sibling and child visitation within southeastern U.S. hospital-based maternity units. ⋯ : Nurses should examine current sibling and child visitation policies in their institutions to determine the need for revision, elimination, or creation of new policies. Moreover, continued research study on child and sibling visitation and related issues is warranted to generate updated evidence to support policies.