Birth coaching makes little difference.
For the most part, it does not matter whether the mother is coached, the researchers report, noting that further study must be done to determine whether bladder problems were permanent.
"Oftentimes, it's best for the patient to do what's more comfortable for her," said Dr. Steven Bloom, Interim Chair of Obstetrics and Gynecology at the university.
Researchers focused on second-stage labor--the time during which the cervix is fully dilated and the baby begins to descend. This report follows an earlier one that found an increase in pelvic-floor problems among coached women.
The new study involved 320 women at Parkland Memorial Hospital in Dallas who were giving birth for the first time. The women had uncomplicated pregnancies and did not receive epidural anesthesia. They were randomly assigned, with both groups tended by nurse-midwives. Of the two groups, 163 were coached to push for 10 seconds during a contraction, and 157 were told to "do what comes naturally."
For women who were randomly assigned to the coaching group, the second stage of labor was shortened by 13 minutes, from 59 to 46 minutes.
"There were no other findings to show that coaching or not coaching was advantageous or harmful," Dr. Bloom said.
The earlier study, reported in the May 2005 issue of Obstetrics and Gynecology, involved the same group of women. In that study, researchers investigated whether coaching caused long-term problems in the pelvic region.
Of the 320 women in the study, 128 returned for testing three months later. The coached women, researchers reported, had smaller bladder capacity and a decreased "first urge to void"--the volume at which a woman wanted to pass urine. However, over time, the bladder function can return to normal.
"Whether these functional changes have long-term consequences, I'm not ready to say," said Dr. Kenneth Leveno, professor of obstetrics and gynecology and senior author of both studies. "We don't want to alarm patients about this."
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|Publication:||Nutrition Health Review|
|Date:||Jun 22, 2005|
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