ArticleBirth (Berkeley, Calif.)2017
Midwives' Management during the Second Stage of Labor in Relation to Second-Degree Tears-An Experimental Study.
Article in Birth (Berkeley, Calif.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03770962 (One Plus One Equals Two - Will That do? A Randomized Controlled Trial to Evaluate Collegial Midwifery Practice to Prevent Perineal Trauma), which is not on this map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
One Plus One Equals Two - Will That do? A Randomized Controlled Trial to Evaluate Collegial Midwifery Practice to Prevent Perineal Trauma
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Effectiveness of Perineal Protection Devices in Reducing Birth-Related Perineal Trauma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and GRADE Assessment.International urogynecology journal · 2026Pooled it
- Hyaluronidase for reducing perineal trauma.The Cochrane database of systematic reviews · 2024Pooled it
- Pelvic floor symptoms and quality of life 1 year postpartum in Swedish primiparous women-A follow-up of a randomized controlled trial.Acta obstetricia et gynecologica Scandinavica · 2026Trial
- Three-dimensional endoanal ultrasound measurements for the assessment of perineal body size in a cohort of Swedish nulligravidae.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Impact of maternal age on the risk of perineal injury and obstetric anal sphincter injury in nulliparous women.Archives of gynecology and obstetrics · 2026Article
- A concept analysis of the term midwifery intervention: A scoping review.European journal of midwifery · 2026Review
- Clinical guidance paper VVOG-CRGOLFB prevention and management of obstetrical perineal trauma.European journal of obstetrics & gynecology and reproductive biology: X · 2025Article
- The PLUS study: efficacy of triclosan coated suture (VicrylPlusMaternal health, neonatology and perinatology · 2025Article
- Subclassification of second-degree tears at delivery: creation and reported outcomes.BMC pregnancy and childbirth · 2025Article
- Improving apgar scores and reducing perineal injuries through midwife-led quality improvements: an observational study in Uganda.BMC public health · 2025Observational
- Pelvic floor symptoms according to the severity of second-degree perineal tears within 12 months post-partum: A longitudinal prospective cohort study.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Article
- Complications 8 weeks after an obstetric second-degree perineal laceration in relation to body mass index.International urogynecology journal · 2024Article
- Patient awareness, knowledge, and acceptability of antenatal perineal massage: A single-center cross-sectional study from Saudi Arabia.European journal of midwifery · 2024Article
- Three-dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Development and initial validation of a Swedish inventory to screen for symptoms of deficient perineum in women after vaginal childbirth: 'Karolinska Symptoms After Perineal Tear Inventory'.BMC pregnancy and childbirth · 2022Article
- Effect of Flexible Sacrum Position on Maternal and Neonatal Outcomes in Public Health Facilities, Amhara Regional State, Ethiopia: A Quasi-Experimental Study.International journal of environmental research and public health · 2022Article
- Prolonged passive second stage of labor in nulliparous women-Prevalence and risk factors: A historical cohort study.Acta obstetricia et gynecologica Scandinavica · 2022Article
- Aspects of Pelvic Floor Protection in Spontaneous Delivery - a Review.Geburtshilfe und Frauenheilkunde · 2022Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMost women who give birth for the first time experience some form of perineal trauma. Second-degree tears contribute to long-term consequences for women and are a risk factor for occult anal sphincter injuries. The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second-degree tears among primiparous women.
methodsAn experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro-iliac joints, and 3) a two-step head-to-body delivery was compared with standard care. Crude and Adjusted OR (95% CI) were calculated between the intervention and the standard care group, for the various explanatory variables.
resultsA total of 597 primiparous women participated in the study, 296 in the intervention group and 301 in the standard care group. The prevalence of second-degree tears was lower in the intervention group: [Adj. OR 0.53 (95% CI 0.33-0.84)]. A low prevalence of episiotomy was found in both groups (1.7 and 3.0%). The prevalence of epidural analgesia was 61.1 percent. Despite the high use of epidural analgesia, the midwives in the intervention group managed to use the intervention.
conclusionIt is possible to reduce second-degree tears among primiparous women with the use of a multifaceted midwifery intervention without increasing the prevalence of episiotomy. Furthermore, the intervention is possible to employ in larger maternity wards with midwives caring for women with both low- and high-risk pregnancies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.