Enabling maternal physiological birth: A systematic review of midwives’ practices during the second stage of labour - 8362: COST Action Birth Conference: Lisbon

Rationale:
Identification of aspects of midwifery care that optimise and interrupt the physiological processes for women and infants during childbirth is highlighted as a key midwifery research priority (Kennedy et al., 2016; WHO 2018). Subsequently, international midwifery researchers undertook a systematic review related to midwives’ practice during the second stage of labour aiming to improve the quality of intrapartum care, inform education and future research.
Method:
Systematic search of PubMed, EMBASE.com, Cumulative Index to Nursing and Allied Health Literature. PsycINFO, Maternity and Infant Care Database, MIDIRS and The Cochrane Library were undertaken. MeSH terms were mainly utilised with no language/publication date restrictions applied. Covidence software aided with screening and data extraction. Included studies were assessed for risk of bias and reference lists hand searched. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; Registration CRD42018088300).
Results/Conclusions:
The review comprehensively collated pertinent literature by initially retrieving over 8000 hits. Following analysis and synthesis, findings revealed specific practices regarding second stage of labour e.g. birth positions, care of perineum and pushing techniques. There is however, a dearth of evidence regarding how midwives enable women during the second stage of labour to optimise physiological birth and ultimately improve the quality of intrapartum care.
Implications:
Midwifery practice can be influenced by education and cultural practices, but ultimately should be informed by up-to-date research evidence. This systematic review helps formulate global midwifery practice, education and future research recommendations to support high quality intrapartum care during the second stage of labour.