Regulated Expiratory Breathing Method During Childbirth
Condition: Childbirth
Study type: Interventional

Summary: 
      The factors affecting the rate of primary caesarean section births are complex, and
      identifying interventions to reduce this rate is challenging. Effective interventions
      targeting at women are mainly represented by Childbirth training workshops, psychoeducation
      and psychosocial couple-based programs. Considering non medical interventions targeting
      mothers, the pattern of breathing during labor that can help for vaginal delivery is a
      controversial topic. There are no data to support a policy of directed maternal breathing or
      pushing during vaginal delivery.

      The abdomino-perineal concept was originally a postpartum rehabilitation technique.
      Currently, applications are increasing. During labor, expiration channeled by a flow
      regulator device offers support to women enduring the pain of uterine contractions. During
      the second stage, the expiratory regulated pushing allows a long, efficient and very
      intuitive push.

      The use of this regulated expiratory breathing method was introduced in the study unit in
      January 2018. Despite a positive experience both reported by women and midwives,
      investigators have so far only subjective feedback without objective measurable clinical
      impact.

      As a result, investigators are conducting this scientific study whose main objective is:

      - To Evaluate the impact of a regulated expiratory breathing method on childbirth process .
    

Detailed description: 
      Rates of cesarean delivery continue to rise worldwide, with recent (2016) reported rates of
      24.5% in Western Europe, 32% in North America, and 41% in South America.

      Primary cesarean deliveries account for more than half of all cesarean deliveries, and the
      most common indication for repeat cesarean delivery is previous cesarean delivery.

      Consequently, the reduction in primary cesarean delivery rate represents a meaningful
      objective.

      The factors affecting the rate of primary caesarean section births are complex, and
      identifying interventions to reduce this rate is challenging. Effective interventions
      targeting at women are mainly represented by Childbirth training workshops, psychoeducation
      and psychosocial couple-based programs. Considering non medical interventions targeting
      mothers, the pattern of breathing during labor that can help for vaginal delivery is a
      controversial topic. There are no data to support a policy of directed maternal breathing or
      pushing during vaginal delivery.

      The abdomino-perineal concept was originally a postpartum rehabilitation technique.
      Currently, applications are increasing. Currently, applications are increasing. During labor,
      expiration channeled by a flow regulator device offers support to women enduring the pain of
      uterine contractions. During the second stage, the expiratory regulated pushing allows a
      long, efficient and very intuitive push.

      The use of this regulated expiratory breathing method was introduced in the study unit in
      January 2018. Despite a positive experience both reported by women and midwives, we
      investigators have so far only subjective feedback without objective measurable clinical
      impact.

      As a result, investigators are conducting this scientific study whose main objective is:

      - To Evaluate the impact of a regulated expiratory breathing method on childbirth process .
    

Intervention name(s): expiration mouthpiece used during breathing exercises to ensure a constant ventilatory flowrate.
Intervention type(s): Device
Intervention description(s): women enrolled in WINNER-FLOW-URO-MG group will freely use the expiratory mouthpiece device during all their childbirth process.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: delivery; cesarean; expiration; exercise; labor