The Effects Of Pushing Techniques During Second Stage Of Labour

Vaginal births are often associated with some form of trauma to the genital tract, and tears that affect the anal sphincter or mucosa (third- and fourth-degree tears) can cause serious problems. Perineal trauma can occur spontaneously or result from a surgical incision (episiotomy). Different perineal techniques are being used to slow down the birth of the baby's head, and allow the perineum to stretch slowly to prevent injury. Massage, warm compresses and different perineal management techniques are widely used by midwives and birth attendants.

A computer program designed by an independent group of the clinical research centre is creating the randomisation list, in blocks of four to six (randomly chosen by the electronic system and well balanced by centre) and stratified by maternity ward and within maternity wards by both parity (nulliparous vs multiparous) and epidural analgesia use at randomisation. The randomisation and the data collection will be performed at a website available 24 hours a day.

After the midwives-investigators have verified the inclusion and exclusion criteria and collected the signed informed consent, the randomisation will take place. There is no conceivable way to conduct this study on either a double-blinded or single-blinded basis.

Sample The population of our study consists of primigravida hospitalized at Erciyes University Training and Research Hospital. In line with data in the literature, the computations are done considering the fulfilment rate of Valsalva's Manoeuvre pushing as 20% and 50% in spontaneous pushing for fewer interventions through wellness of baby and the mother. Thus, sample volumes to represent the population are p1= 0.20 (control group), p2= 0.50 (experimental group), %95 confidence interval, α= 0.05, β = 0.20, power = 0.80 (1-β) for each group n=82 women, and in total 164 mothers.

Criteria of primigravida in the study; Women are accepted in the study on condition that they are aged 18 and more, primigravida, bearing single foetus between 2500 and 3999gr of birth weight in vertex position, in 38-42 gestation weeks, expected to have spontaneous vaginal labour with no or little risk factors, without obstetrical or medical complications during labour, with a cervical dilatation of 6cm and an amnion sack opening at 3cm of cervical dilatation, and they must also accept to participate in the study.