Comparison of Spontaneous Pushing and Directed Pushing During the Second Stage of Labor Among Chinese Women Without Epidural Analgesia: Protocol for a Noninferior Feasibility Study
File version
Version of Record (VoR)
Author(s)
Roth, Heike
Anderson, Debra
Lu, Hong
Rong, Huijuan
Baird, Kathleen
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
Size
File type(s)
Location
Abstract
Background: Maternal pushing during the second stage of labor could influence labor progress and maternal-neonatal outcomes. Although the image of health care providers directing the laboring women to push during the second stage of labor could be commonly observed globally, this practice is not sufficiently researched and is questioned regarding its effectiveness and outcomes on the mother and baby. Meanwhile, a strategy referred to as “spontaneous pushing,” which supports women to push by following their bodily urges, has been evaluated in several trials. However, in China, spontaneous pushing is not common practice. Notwithstanding the evaluation of spontaneous pushing, there is a lack of high-quality evidence to support either strategies of directed pushing or spontaneous pushing. Objective: This study aims to test the feasibility of a future randomized controlled trial to compare the effects of spontaneous pushing and directed pushing during the second stage of labor for maternal and neonatal outcomes in China. Methods: A nonrandomized, single-group, noninferiority feasibility study will be conducted in a public hospital in Hebei Province, China. In total, 105 women meeting the selection criteria will be recruited to receive the intervention (spontaneous pushing), while 105 sets of medical notes from women who received routine care (directed pushing) will be identified and reviewed to compare outcomes for both cohorts. A mixed methods approach will be used to assess primary outcomes (feasibility and acceptability) and secondary outcomes (effectiveness). Results: Data collection took place between May and October 2023. A total of 110 women were invited to participate in the intervention of spontaneous pushing. Midwives’ interviews were conducted and will be transcribed for analysis in March 2024. The data analysis is planned to be completed by May 2024. Conclusions: This feasibility study will provide important information by conducting a full-scale clinical trial in the future as well as the potential facilitators and barriers of it. A future randomized controlled trial is likely to have considerable policy and funding impacts regarding pushing management during the second stage of labor and improvement in women’s childbirth experience. Trial Registration: Chinese Clinical Trial Register ChiCTR2300071178; https://tinyurl.com/mudtnbft International Registered Report Identifier (IRRID): DERR1-10.2196/55701
Journal Title
JMIR Research Protocols
Conference Title
Book Title
Edition
Volume
13
Issue
Thesis Type
Degree Program
School
Publisher link
DOI
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
© Jiasi Yao, Heike Roth, Debra Anderson, Hong Lu, Huijuan Rong, Kathleen Baird. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 26.03.2024. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included.
Item Access Status
Note
Access the data
Related item(s)
Subject
Health services and systems
Public health
Persistent link to this record
Citation
Yao, J; Roth, H; Anderson, D; Lu, H; Rong, H; Baird, K, Comparison of Spontaneous Pushing and Directed Pushing During the Second Stage of Labor Among Chinese Women Without Epidural Analgesia: Protocol for a Noninferior Feasibility Study, JMIR Research Protocols, 2024, 13, pp. e55701