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Carpenter J, Burns E, Smith L. Factors Associated With Normal Physiologic Birth for Women Who Labor In Water: A Secondary Analysis of A Prospective Observational Study. J Midwifery Womens Health 2022; 67:13-20. [PMID: 35029843 PMCID: PMC9302129 DOI: 10.1111/jmwh.13315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Research to understand factors associated with normal physiologic birth (unassisted vaginal birth, spontaneous labor onset without epidural analgesia, spinal, or general anesthetic, without episiotomy) is required. Laboring and/or giving birth in water has been shown to be associated with a high proportion of physiologic birth but with little understanding of factors that may influence this outcome. This study explored factors associated with normal physiologic birth for women who labored in water. METHODS We conducted a secondary analysis of a UK-based prospective observational study of 8064 women at low risk of childbirth complications who labored in water. Consecutive women were recruited from birth settings in England, Scotland, and Northern Ireland. Planned place of birth, maternal characteristics, intrapartum events, and maternal and neonatal outcomes were measured. Univariable and multivariable logistic regression modelling explored factors associated with normal physiologic birth. RESULTS In total, 5758 (71.4%) of women who labored in water had a normal physiologic birth. Planned birth in the community (adjusted odds ratio [aOR], 2.58; 95% CI, 2.22-2.99) or at an alongside midwifery unit (aOR, 1.21; 95% CI, 1.04-1.41) was positively associated with normal physiologic birth compared with planned birth in an obstetric unit. Duration of second stage (aOR, 0.66; 95% CI, 0.62-0.70), duration in the pool [aOR, 0.93; 95% CI, 0.90-0.96), and birth weight of the neonate (aOR, 0.74; 95% CI, 0.65-0.85) were negatively associated with normal physiologic birth. Parity was not associated with normal physiologic birth in multivariate analyses. DISCUSSION Our findings largely reflected wider research, both in and out of water. We found midwifery-led birth settings may increase the likelihood of normal physiologic birth among healthy women who labor in water, irrespective of parity. This association supports growing evidence demonstrating the importance of planned place of birth on reducing intervention rates and adds to research on labor and birth in water.
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Affiliation(s)
- Jane Carpenter
- Oxford School of Nursing and MidwiferyOxford Brookes UniversityOxfordUnited Kingdom
| | - Ethel Burns
- Oxford School of Nursing and MidwiferyOxford Brookes UniversityOxfordUnited Kingdom
| | - Lesley Smith
- Faculty of Health SciencesHull UniversityHullUnited Kingdom
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Morales-Luengo F, Salamanca-Zarzuela B, Urueña SM, García CE, Carboner SC. External influences on birth deliveries: Lunar gravitational and meteorological effects. An Pediatr (Barc) 2020. [DOI: 10.1016/j.anpede.2020.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Morales-Luengo F, Salamanca-Zarzuela B, Marín Urueña S, Escribano García C, Caserío Carbonero S. [External influences on birth deliveries: Lunar gravitational and meteorological effects]. An Pediatr (Barc) 2020; 93:367-373. [PMID: 32278668 DOI: 10.1016/j.anpedi.2020.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To investigate the influence of external factors such as lunar and meteorological effects on the frequency of birth deliveries. It includes the lunar gravitational force using the scarcely investigated lunar apogee and perigee (furthest and closest distance to earth, respectively). MATERIAL AND METHODS A retrospective study was conducted by reviewing the medical records of all spontaneous single deliveries during a 4 year period (2015-2018). A statistical analysis was performed on the relationship of the deliveries using birth rates with qualitative lunar variables (four classic phases, lunar apogee- perigee, and super moons) and quantitative atmospheric variables (mean atmospheric pressures, mean temperature, and mean wind velocity). RESULTS No relationship was found between the variables studied and the birth rate. There were periods with more births in the months of May and June. CONCLUSION Despite the myth on the meteorological, and in particular, the lunar influence on birth deliveries, no statistical association was found to support this. Furthermore, the classic moon phases and the lunar gravitational force do not seem to trigger birth delivery either.
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Affiliation(s)
| | | | - Sara Marín Urueña
- Unidad de Neonatología, Hospital Universitario Río Hortega, Valladolid, España
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Breschi M, Ruiu G, Gonano G. One day is not as good as another…at least not across the entire territory of Italy: an analysis of the differences in the daily distribution of births across Italian macro-regions, 1999–2016. GENUS 2019. [DOI: 10.1186/s41118-019-0062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Prosser SJ, Barnett AG, Miller YD. Factors promoting or inhibiting normal birth. BMC Pregnancy Childbirth 2018; 18:241. [PMID: 29914395 PMCID: PMC6006773 DOI: 10.1186/s12884-018-1871-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 05/31/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In response to rising rates of medical intervention in birth, there has been increased international interest in promoting normal birth (without induction of labour, epidural/spinal/general anaesthesia, episiotomy, forceps/vacuum, or caesarean section). However, there is limited evidence for how best to achieve increased rates of normal birth. In this study we examined the role of modifiable and non-modifiable factors in experiencing a normal birth using retrospective, self-reported data. METHODS Women who gave birth over a four-month period in Queensland, Australia, were invited to complete a questionnaire about their preferences for and experiences of pregnancy, labour, birth, and postnatal care. Responses (N = 5840) were analysed using multiple logistic regression models to identify associations with four aspects of normal birth: onset of labour, use of anaesthesia, mode of birth, and use of episiotomy. The probability of normal birth was then estimated by combining these models. RESULTS Overall, 28.7% of women experienced a normal birth. Probability of a normal birth was reduced for women who were primiparous, had a history of caesarean, had a multiple pregnancy, were older, had a more advanced gestational age, experienced pregnancy-related health conditions (gestational diabetes, low-lying placenta, high blood pressure), had continuous electronic fetal monitoring during labour, and knew only some of their care providers for labour and birth. Women had a higher probability of normal birth if they lived outside major metropolitan areas, did not receive private obstetric care, had freedom of movement throughout labour, received continuity of care in labour and birth, did not have an augmented labour, or gave birth in a non-supine position. CONCLUSIONS Our findings highlight several relevant modifiable factors including mobility, monitoring, and care provision during labour and birth, for increasing normal birth opportunity. An important step forward in promoting normal birth is increasing awareness of such relationships through patient involvement in informed decision-making and implementation of this evidence in care guidelines.
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Affiliation(s)
- Samantha J. Prosser
- School of Psychology, The University of Queensland, Brisbane, Australia
- School of Public Health & Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD 4059 Australia
| | - Adrian G. Barnett
- School of Public Health & Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD 4059 Australia
| | - Yvette D. Miller
- School of Public Health & Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD 4059 Australia
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Barra M, Lindstrøm JC, Adams SS, Augestad LA. Seasonally adjusted birth frequencies follow the Poisson distribution. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015; 135:2154-8. [PMID: 26674035 DOI: 10.4045/tidsskr.14.1506] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Variations in birth frequencies have an impact on activity planning in maternity wards. Previous studies of this phenomenon have commonly included elective births. A Danish study of spontaneous births found that birth frequencies were well modelled by a Poisson process. Somewhat unexpectedly, there were also weekly variations in the frequency of spontaneous births. Another study claimed that birth frequencies follow the Benford distribution. Our objective was to test these results. MATERIAL AND METHOD We analysed 50,017 spontaneous births at Akershus University Hospital in the period 1999-2014. To investigate the Poisson distribution of these births, we plotted their variance over a sliding average. We specified various Poisson regression models, with the number of births on a given day as the outcome variable. The explanatory variables included various combinations of years, months, days of the week and the digit sum of the date. RESULTS The relationship between the variance and the average fits well with an underlying Poisson process. A Benford distribution was disproved by a goodness-of-fit test (p < 0.01). The fundamental model with year and month as explanatory variables is significantly improved (p < 0.001) by adding day of the week as an explanatory variable. Altogether 7.5% more children are born on Tuesdays than on Sundays. The digit sum of the date is non-significant as an explanatory variable (p = 0.23), nor does it increase the explained variance. INERPRETATION: Spontaneous births are well modelled by a time-dependent Poisson process when monthly and day-of-the-week variation is included. The frequency is highest in summer towards June and July, Friday and Tuesday stand out as particularly busy days, and the activity level is at its lowest during weekends.
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Affiliation(s)
| | | | | | - Liv A Augestad
- Avdeling for helseledelse og helseøkonomi Universitetet i Oslo og Helsetjenesteforskning Akershus universitetssykehus
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Back to normal: A retrospective, cross-sectional study of the multi-factorial determinants of normal birth in Queensland, Australia. Midwifery 2015; 31:818-27. [PMID: 25921954 DOI: 10.1016/j.midw.2015.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 02/24/2015] [Accepted: 04/07/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND currently, care providers and policy-makers internationally are working to promote normal birth. In Australia, such initiatives are being implemented without any evidence of the prevalence or determinants of normal birth as a multidimensional construct. This study aimed to better understand the determinants of normal birth (defined as without induction of labour, epidural/spinal/general anaesthesia, forceps/vacuum, caesarean birth, or episiotomy) using secondary analyses of data from a population survey of women in Queensland, Australia. METHODS women who birthed in Queensland during a two-week period in 2009 were mailed a survey approximately three months after birth. Women (n=772) provided retrospective data on their pregnancy, labour and birth preferences and experiences, socio-demographic characteristics, and reproductive history. A series of logistic regressions were conducted to determine factors associated with having labour, having a vaginal birth, and having a normal birth. FINDINGS overall, 81.9% of women had labour, 66.4% had a vaginal birth, and 29.6% had a normal birth. After adjusting for other significant factors, women had significantly higher odds of having labour if they birthed in a public hospital and had a pre-existing preference for a vaginal birth. Of women who had labour, 80.8% had a vaginal birth. Women who had labour had significantly higher odds of having a vaginal birth if they attended antenatal classes, did not have continuous fetal monitoring, felt able to 'take their time' in labour, and had a pre-existing preference for a vaginal birth. Of women who had a vaginal birth, 44.7% had a normal birth. Women who had a vaginal birth had significantly higher odds of having a normal birth if they birthed in a public hospital, birthed outside regular business hours, had mobility in labour, did not have continuous fetal monitoring, and were non-supine during birth. CONCLUSIONS these findings provide a strong foundation on which to base resources aimed at increasing informed decision-making for maternity care consumers, providers, and policy-makers alike. Research to evaluate the impact of modifying key clinical practices (e.g., supporting women׳s mobility during labour, facilitating non-supine positioning during birth) on the likelihood of a normal birth is an important next step.
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Chiavegatto Filho ADP. Partos cesáreos e a escolha da data de nascimento no Município de São Paulo. CIENCIA & SAUDE COLETIVA 2013; 18:2413-20. [DOI: 10.1590/s1413-81232013000800026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Accepted: 10/21/2012] [Indexed: 11/22/2022] Open
Abstract
O Brasil tem uma das maiores taxas de partos cesáreos do mundo, e esse valor tem aumentado anualmente. O presente estudo teve como objetivo analisar possíveis mudanças na data de nascimento decorrentes desse aumento. Foram obtidos os dados dos 1.933.137 nascidos vivos ocorridos no Município de São Paulo entre 2001 e 2010, divididos segundo tipo de parto e data exata de nascimento. Em 2001, a taxa de cesarianas foi de 48,9%, passando a 56,8% em 2010. O dia da semana com menor número de nascimentos (domingo) aumentou a diferença em relação aos outros dias de 111,4 (IC95%: 101,7 - 121,0) em 2001 para 143,1 (IC95%: 135,0 - 151,3) em 2010. Os dois dias com menos nascimentos (Natal e Dia de Finados), apresentaram diferença estatisticamente significativa em relação aos outros dias do ano (p < 0.05) durante praticamente todo o período (a exceção foi o Dia de Finados em 2009). A data com o maior número de nascimentos (Dia Internacional da Mulher) apresentou diferença significativa em 2005 e 2010. O aumento no número de partos cesáreos tem tido efeito significativo na data de nascimento, o que pode trazer consequências no planejamento administrativo de instituições de saúde.
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CAI YI, LAI DEJIAN, WALLER DOROTHYKIM, DU XIANGLIN, BURAU KEITH, SYMANSKI ELAINE. STATISTICAL ANALYSIS OF THE DAY OF THE WEEK EFFECT ON BIRTHS IN HARRIS COUNTY, TEXAS. J BIOL SYST 2013. [DOI: 10.1142/s0218339013500149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The frequency of births by day of the week has been reported by several studies without a formal statistical analysis. Births occurring on weekends have been consistently found to be less frequent than births on weekdays. In this study, we compared different statistical methods to assess the effect of the day of the week on the timing of births. We employed two statistical methods, two-way ANOVA and two-way Friedman's test, to analyze the daily variations of 222,735 births from 2005 to 2007 in Harris County, Texas. Both of the statistical tests indicated that births were not uniformly distributed by day of the week. Pairwise comparisons demonstrated that the births occurring on weekends were significantly less frequent than births occurring on weekdays. Our study together with other empirical studies would provide useful information for improving hospital management and the health of infants and their mothers.
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Affiliation(s)
- YI CAI
- The University of Texas School of Public Health, 1200 Herman Pressler, RAS W1006, Houston, TX 77030, USA
| | - DEJIAN LAI
- The University of Texas School of Public Health, 1200 Herman Pressler, RAS W1006, Houston, TX 77030, USA
- Faculty of Statistics, Jiangxi University of Finance and Economics, Nanchang, P. R. China
| | - DOROTHY KIM WALLER
- The University of Texas School of Public Health, 1200 Herman Pressler, RAS W1006, Houston, TX 77030, USA
| | - XIANGLIN DU
- The University of Texas School of Public Health, 1200 Herman Pressler, RAS W1006, Houston, TX 77030, USA
| | - KEITH BURAU
- The University of Texas School of Public Health, 1200 Herman Pressler, RAS W1006, Houston, TX 77030, USA
| | - ELAINE SYMANSKI
- The University of Texas School of Public Health, 1200 Herman Pressler, RAS W1006, Houston, TX 77030, USA
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Ochiai AM, Gonçalves FLT, Ambrizzi T, Florentino LC, Wei CY, Soares AVN, De Araujo NM, Gualda DMR. Atmospheric conditions, lunar phases, and childbirth: a multivariate analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2012; 56:661-667. [PMID: 21744100 DOI: 10.1007/s00484-011-0465-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 05/26/2011] [Accepted: 06/08/2011] [Indexed: 05/31/2023]
Abstract
Our objective was to assess extrinsic influences upon childbirth. In a cohort of 1,826 days containing 17,417 childbirths among them 13,252 spontaneous labor admissions, we studied the influence of environment upon the high incidence of labor (defined by 75th percentile or higher), analyzed by logistic regression. The predictors of high labor admission included increases in outdoor temperature (odds ratio: 1.742, P = 0.045, 95%CI: 1.011 to 3.001), and decreases in atmospheric pressure (odds ratio: 1.269, P = 0.029, 95%CI: 1.055 to 1.483). In contrast, increases in tidal range were associated with a lower probability of high admission (odds ratio: 0.762, P = 0.030, 95%CI: 0.515 to 0.999). Lunar phase was not a predictor of high labor admission (P = 0.339). Using multivariate analysis, increases in temperature and decreases in atmospheric pressure predicted high labor admission, and increases of tidal range, as a measurement of the lunar gravitational force, predicted a lower probability of high admission.
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Affiliation(s)
- Angela Megumi Ochiai
- School of Arts, Science and Humanities-Midwifery Department, University of Sao Paulo (USP), Sao Paulo City, Sao Paulo, Brazil.
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Lerchl A, Reinhard SC. Where are the Sunday babies? II. Declining weekend birth rates in Switzerland. Naturwissenschaften 2007; 95:161-4. [PMID: 17891531 DOI: 10.1007/s00114-007-0305-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Revised: 08/28/2007] [Accepted: 08/31/2007] [Indexed: 10/22/2022]
Abstract
Birth dates from almost 3 million babies born between 1969 and 2005 in Switzerland were analyzed for the weekday of birth. As in other countries but with unprecedented amplitude, a very marked non-random distribution was discovered with decreasing numbers of births on weekends, reaching -17.9% in 2005. While most of this weekend births avoidance rate is due to fewer births on Sundays (up to -21.7%), the downward trend is primarily a consequence of decreasing births on Saturdays (up to -14.5%). For 2005, these percentages mean that 3,728 fewer babies are born during weekends than could be expected from equal distribution. Most interestingly and surprisingly, weekend birth-avoiding rates are significantly correlated with birth numbers (r = 0.86), i.e. the lower the birth number per year, the lower the number of weekend births. The increasing avoidance of births during weekends is discussed as being a consequence of increasing numbers of caesarean sections and elective labor induction, which in Switzerland reach 29.2 and 20.5%, respectively, in 2004. This hypothesis is supported by the observation that both primary and secondary caesarean sections are significantly correlated with weekend birth avoidance rates. It is therefore likely that financial aspects of hospitals are a factor determining the avoidance of weekend births by increasing the numbers of caesarean sections.
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Affiliation(s)
- Alexander Lerchl
- School of Engineering and Science, Jacobs University Bremen, Campus Ring 6, D-28759 Bremen, Germany.
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