Regulated Expiratory Breathing Method During Childbirth

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 .

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 .

Eligibility Criteria:
Inclusion Criteria:

* Primiparae
* Singleton pregnancy
* Gestational age ≥ 37 SA
* Fetus in cephalic presentation
* Fetus with a normal weight for a the gestational age
* Spontaneous onset of labor
* Early stage of labor (with cervical dilatation under 3 cm)
* No previous Childbirth training workshops

Exclusion Criteria:

* Parity of at least 2
* Multiple pregnancy
* Intra uterine fetal demise
* Previous uterine scar
* Fetus in Breach presentation
* Non Vertex cephalic presentation
* Narrowed pelvic bone diameters
* A contraindication to vaginal delivery (placenta previa , fibroma previa, ...)
* Previous participation to childbirth training workshops
* Women in an advanced stage of labor with a cervical dilation upon admission over 3 cm
* Women requiring epidural anesthesia
* Refusal of participation