WHO Intrapartum care for a positive childbirth expereince. by Stephanie Heys

2021-05-10 15:25:08 UTC

Really interesting reading that allowed me to be critical of my own/my trusts practice particularly in relation to ‘timings’ and the cascade of intervention, and I have always thought the partogram told us not a great deal, so great to have this in evidence. It does concern me that this states healthy (no risk factors) women - yet it seems such a great proportion, particularly at term have some sort of risk factor/reason for induction now. It would be great to see these recommendations for ALL women unless there’s a seriously good reason not to?

I found this document really informative, and fortunately many aspects of the recommendations I already see in practice. I was surprised to read that the evidence suggests that all women should receive an actively managed third stage with oxytocin, and I feel I need to read around this topic further. I also found it interesting that CCT is only appropriate if the birth attendant and woman feel that it is important for a small reduction in blood loss, and again I feel I need to research this topic further as I have always observed CCT as standard practice alongside active third stage management.

2021-05-10 17:01:52 UTC

Interesting read, astounding that so many interventions that are seen in practice aren't evidence based and yet they continue. It sets such unrealistic expectations for women and their birth companions. When I worked in a birth centre we worked in line with a lot of the recommendations (avoiding unnecessary internal examinations on arrival etc) and the outcomes were generally really positive for those we cared for.

2023-10-21 11:55:43 UTC

aelister14 — 2023-10-21 17:45:22 UTC

I found this really interesting and thought provoking. As already mentioned, one thing that stood out to me was the recommendation for all women to have an active third stage. I am pleased to see that some things criticised in this guideline are not being used in clinical practice e.g. dilation of 1cm/hour. However, often the trajectory of cervical dilation of 1cm every 2 hours is used in practice. Like the guideline says, every labour is unique so it makes you consider what good these timeframes actually do and will practice ever exist without them?

2023-10-25 10:08:10 UTC

Through my own learning I have known about many of these interventions not being evidence based and have read of them separately through different professionals sharing the work of others. To see it come together for the benefit of the women we care for in one place is really helpful. I will be sharing this with my women, birthing people and colleagues.

jferraby21 — 2023-10-25 22:57:44 UTC

I appreciate that this document recognises the 'absence of a standardised definition of effective communication', subsequently offering some key points of guidance around what is expected.

jferraby21 — 2023-10-25 23:00:54 UTC

When reviewing the definitions of the latent & active first stages of labour, it's interesting to see that the definition of the active first stage includes 'more rapid cervical dilatation from 5cm until full dilatation' - more rapid than what?