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OBJECTIVE Maternal expulsive efforts are thought to damage the pelvic floor. We aimed to compare pelvic floor function and anatomy between women who delivered vaginally (VB) versus those with caesarean delivery (CD) prior to the second stage of labour. DESIGN Prospective cohort. SETTING University Hospital Midwifery practice. POPULATION Nulliparas. (More)
OBJECTIVE To measure the length of active labor (first and second stages) in a low-risk population of non-Hispanic white, Hispanic, and American Indian women, and to identify any differences among these ethnic populations. METHODS Descriptive statistics are presented for 1473 low-risk women at term who delivered at the University of New Mexico Hospital.(More)
Genital tract trauma after spontaneous vaginal childbirth is common, and evidence-based prevention measures have not been identified beyond minimizing the use of episiotomy. This study randomized 1211 healthy women in midwifery care at the University of New Mexico teaching hospital to 1 of 3 care measures late in the second stage of labor: 1) warm(More)
  • L L Albers
  • 2000
Of the entire maternity care cycle, the postpartum period occupies the lowest priority in practice, teaching, and research. Despite this, data from research outside the United States show that health problems after birth are very common, may persist over time, and are often under-recognized by care providers. Women's health would be favorably impacted by(More)
We conducted an observational cohort study in three nurse-midwifery services to identify patient characteristics and clinical care measures related to perineal trauma at birth. Data were collected on all women who began care with a nurse-midwife in labor, using an adaptation of the Nurse-Midwifery Clinical Data Set (n = 3,049). Study variables included(More)
This article describes the association among perineal outcomes, selected risk factors, and alternative intrapartum approaches used by nurse-midwives. This nonrandomized concurrent (cohort) study analyzed all spontaneous vaginal births (N = 1211) attended by nurse-midwives at a university hospital over a 2-year period. Univariate analysis was used to(More)
  • L L Albers
  • 2001
Evidence-based care has become the new standard in the clinical disciplines. It represents a paradigm shift for clinicians, toward greater inclusion of research findings in patient care decisions. Randomized trials are the "gold standard" in clinical research and provide the strongest evidence for a treatment or intervention. But, randomized trials have(More)
An abbreviated version of the Nurse-Midwifery Clinical Data Set was used to gather data on all women (n = 3,049) who began intrapartum care with a nurse-midwife in three sites. Demographic information, intrapartum care, and outcomes were recorded. The association of ambulation in labor with operative delivery was examined in a low-risk sample (n = 1,678) of(More)
Genital tract trauma is common following vaginal childbirth, and perineal pain is a frequent symptom reported by new mothers. The following techniques and care measures are associated with lower rates of obstetric lacerations and related pain following spontaneous vaginal birth: antenatal perineal massage for nulliparous women, upright or lateral positions(More)
The active phase of first stage labor is generally defined as the period between 3 cm to 4 cm to complete cervical dilatation, in the presence of regular uterine contractions. Most women will experience this portion of labor within hospital obstetric units, where care commonly features restriction to bed, electronic fetal monitoring, early treatment of(More)