Friday, July 26, 2019

Are low risk women in normal labor receiving too many interventions Essay

Are low risk women in normal labor receiving too many interventions - Essay Example In normal labor the package of routine care becomes very flexible one. These interventions depend upon the place of delivery; at home most of the time moral support and attachment are the major interventions while at a well-equipped health facility the staff utilizes more interventions in the management of any pregnant women. (2) In the UK, the routine practice at the time of delivery is carrying out various activities related to any task of maternal and fetal care. Usually, the intensity and frequency of these activities crosses any line or level recommended. Most of the time these activities are carried out without any supportive evidence and at times these may become dangerous instead of beneficial. Findings from the study carried out by Hofmeyr stressed on the inconclusive evidence of routine use of oxytocin, routine amniotomy, continuous electronic fetal heart rate, etc (2). Use of analgesia has got its own untoward effects. Epidural analgesia may convert the normal labor to a prolonged labor at one end; further, it may also increases the probability of performing other interventions, as they are needed due to the long duration of labor. So after getting epidural analgesia which results in prolonged labor eventually results in exhaustion on the side of the woman with weaker and infrequent labor pains fro which drugs for augmentation are required supported by episiotomy. (3) The frequency and types of interventions used during intrapartum period in the UK especially in low risk women has not been looked for and estimated. (4) There are strong recommendations not to overuse interventions when they are not indicated. (5) There is a common agreement of obstetricians and midwives that most of the obstetric interventions cannot be explained. (6) Therefore, as is well known that these interventions are at times dangerous especially when used in excess and at the same time the frequency of use of these interventions is not available. To get reliable information on the utilization of these interventions appropriately a study is proposed with a research question of are low risk women in normal labor receiving too many interventions Objectives To look for level of intrapartum interventions used in normal labor in the UK. Methodology Study design A cross sectional survey will be carried out to reach the objective of this study. Sampling frame A sampling frame of all the consultant maternity units in Great Britain was obtained from the annual returns to the Royal College of Obstetricians and Gynecologist (RCOG). This list contains the data, which is believed to be almost complete. Aim was to complete data collection in one year. The sampling frame captured 237 hospitals but the final number of hospital to be included in the study was 226. The hospitals with less than 1000 births per annum were excluded from the list. Sample size determination To get an appropriate number of women to capture all major interventions, a sample size of 4040 women was finalized. It was decided to collect information from 40 women from each hospital to complete the data collection in an appropriate time without putting extra burden on the hospitals. For this purpose, 101 hospitals were randomly selected from the sampling frame and from each hospital

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