Trial reportBMJ open2024
Impact of collegial midwifery assistance during second stage of labour on women's experience: a follow-up from the Swedish Oneplus randomised controlled trial.
Trial report in BMJ open, 2024. 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. Not yet cited in PubMed.
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The trial behind it
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One Plus One Equals Two - Will That do? A Randomized Controlled Trial to Evaluate Collegial Midwifery Practice to Prevent Perineal Trauma
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare experiences of the second stage of labour in women randomised to assistance by one or by two midwives to reduce severe perineal trauma (SPT).
designAnalysis of a secondary outcome within the Swedish Oneplus multicentre randomised trial.
settingFive obstetric units in Sweden between December 2018 and March 2020.
participantsInclusion criteria in the Oneplus trial were women opting for their first vaginal birth from gestational week 37+0 with a singleton pregnancy and a live fetus in the vertex presentation. Further inclusion criteria were language proficiency in Swedish, English, Arabic or Farsi. Exclusion criteria were multiple pregnancies, intrauterine fetal demise and planned caesarean section. Of the 3059 women who had a spontaneous vaginal birth, 2831 women had consented to participate in the follow-up questionnaire.
interventionsWomen were randomly assigned (1:1) to assistance by two midwives (intervention group) or one midwife (standard care) when reaching the second stage of labour. OUTCOME MEASURES: Data were analysed by intention to treat. Comparisons between intervention and standard care regarding experiences of the second stage of labour were evaluated with items rated on Likert scales. The Student's t-test was used to calculate mean differences with 95% CIs.
resultsIn total 2221 (78.5%) women responded to the questionnaire. There were no statistically significant differences regarding women's experiences of being in control, feelings of vulnerability or pain. Women randomised to be assisted by two midwives agreed to a lesser extent that they could handle the situation during the second stage (mean 3.18 vs 3.26, 95% CI 0.01 to 0.15). Conducted subgroup analyses revealed that this result originated from one of the study sites.
conclusionsThe intervention's lack of impact on the experience of the second stage is of importance considering the reduction in SPT when being assisted by two midwives. TRIAL REGISTRATION NUMBER: NCT03770962.
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