FACTORS AFFECTING THE USE OF MATERNAL POSITIONS FOR THE SECOND STAGE OF LABOR: A SURVEY OF CERTIFIED NURSE-MIDWIVES.
Contributors: Rush University, College Of Nursing.
Published: 1996
Number of pages: 214
Subjects: Health Sciences, Nursing.; Health Sciences, Obstetrics and Gynecology.
Description: A national survey of 800 Certified Nurse-Midwives (CNMs) was conducted from April through June, 1994. The purpose of the survey was twofold: (1) to study the extent to which various positions were used for the second stage of labor by the clients of CNMs; and (2) to describe factors that affect their use. Eight maternal positions were operationally defined for the study: (1) lithotomy; (2) dorsal recumbent; (3) sitting upright; (4) side-lying; (5) all-fours; (6) kneeling; (7) squatting; and (8) standing. Questions pertaining to clinical parameters such as fetal position and fetal monitoring and how each of these affected the use or the recommendation of the use of each position were included. Information on client, practice, and CNM individual characteristics was also gathered. The total response rate was 563 (70.4%). Of those, 539 (54.4%) were usable for analysis.

The most frequently used position by the CNMs for pushing and for birth was the sitting position. Side-lying and dorsal recumbency were the next most frequently used. The lithotomy position was rarely used by the CNMs. Two hundred sixty five CNMs (60.5%) use non-lithotomy exclusively.

The use of delivery tables and certain interventions were associated with the use of both the lithotomy and the dorsal recumbent positions. More limited use of interventions and the use of birthing beds were associated with the use of alternative positions. Lower CNM self-reported autonomy scores were associated with the use of the lithotomy and dorsal positions and higher autonomy scores were associated with the use of alternative positions. Several relationships between position use and a number of other CNM personal and practice characteristics were identified. Positions that the CNMs encouraged were used more in their practices. The lithotomy position was discouraged by most of the CNMs. Finally, the direction of influence of various parameters on position use for the second stage of labor was identified. Maternal preference, for example, made the use of any non-lithotomy position more likely.

The CNMS used alternative positions predominantly. A number of factors, perhaps unique to nurse-midwifery practice, influence the use or the recommendation of use of these positions.
Notes: Source: Dissertation Abstracts International, Volume: 57-02, Section: B, page: 0988.

Thesis (D.N.SC.)--RUSH UNIVERSITY, COLLEGE OF NURSING, 1996.

School code: 0591.