Management of the woman in normal second stage of labour: a review

Perinatal urinary and fecal incontinence: suffering in silence

This article focuses on the prevention, identification, and management of urinary and fecal incontinence in the perinatal period. Both urinary and fecal incontinence are common concerns affecting women throughout pregnancy, intrapartum, and postpartum. These are the problems that are not approached by healthcare providers during the initial antepartal assessment, nor are they fully investigated after delivery. Many women hesitate to disclose this information. Women tend to consider this to be a minor discomfort of pregnancy and a consequence resulting from childbirth in the postpartum period. Intervention strategies and nursing care components in the perinatal period will be presented.

Maternal behaviour during spontaneous and directed pushing in the second stage of labour

It has become custom and practice within the midwifery and obstetric professions in the English-speaking western world for women to be required to follow very specific instructions on how to push in the second stage of labour. There is very little literature on the behaviour of women using spontaneous pushing in the second stage of labour. In a pilot study of a randomized controlled trial comparing spontaneous (n = 15) with directed (n = 17) pushing, the behaviour of the women was observed and recorded. The findings from the observational part of the study are reported in this paper. When pushing spontaneously women do not instinctively take a deep breath, they do not start expulsive effort with the commencement of the contraction, and they use both open and closed glottis pushing. In order to assist women in the second stage of labour, those caring for them should be aware of what is normal behaviour when women are using spontaneous expulsive effort.