Effect of alternatively designed hospital birthing rooms on the rate of vaginal births: Multicentre randomised controlled trial Be-Up
There is limited research into the effects of the birth environment on birth outcomes. To investigate the effect of a hospital birthing room designed to encourage mobility, self-determination and uptake of upright maternal positions in labour on the rate of vaginal births. The multicentre randomised...
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Published in | Women and birth : journal of the Australian College of Midwives Vol. 36; no. 5; pp. 429 - 438 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Netherlands
Elsevier Ltd
01.09.2023
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Subjects | |
Online Access | Get full text |
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Summary: | There is limited research into the effects of the birth environment on birth outcomes.
To investigate the effect of a hospital birthing room designed to encourage mobility, self-determination and uptake of upright maternal positions in labour on the rate of vaginal births.
The multicentre randomised controlled trial Be-Up, conducted from April 2018 to May 2021 in 22 hospitals in Germany, included 3719 pregnant women with a singleton pregnancy in cephalic position at term. In the intervention birthing room, the bed was removed or covered in a corner of the room and materials were provided to promote upright maternal positions, physical mobility and self-determination. No changes were made in the control birthing room.
The primary outcome was probability of vaginal births; secondary outcomes were episiotomy, perineal tears degree 3 and 4, epidural anaesthesia, “critical outcome of newborns at term”, and maternal self-determination (LAS). Analysis: intention-to-treat.
The rate of vaginal births was 89.1 % (95 % CI 87.5–90.4%; n = 1836) in the intervention group and 88.5 % (95 % CI 87.0–89.9 %; n = 1863) in the control group. The risk difference in the probability of vaginal birth was + 0.54 % (95 % CI − 1.49 % to 2.57 %), the odds ratio was 1.06 (95 % CI 0.86–1.30). Neither the secondary endpoints nor serious adverse events showed significant differences. Regardless of group assignment, there was a significant association between upright maternal body position and maternal self-determination.
The increased vaginal birth rates in both comparison groups can be explained by the high motivation of the women and the staff. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 |
ISSN: | 1871-5192 1878-1799 |
DOI: | 10.1016/j.wombi.2023.02.009 |