Maternal Morbidities and Neonatal Complications
In the following paper, I shall review the two major practices of childbirth about both maternal as well as foetal wellbeing. In this regard, I shall review two commonly used delivery procedures during childbirth and contrast them to one another. These procedures include the Valsalva Manoeuvre and the Spontaneous Pushing. In essence, I shall review both methods of childbirth about time constraints experienced during the period of childbirth (Albers et al., 2005). Furthermore, in reviewing these two methods of delivery, I will also consider the primary purpose of midwifery, which is to observe patient safety at all times, thereby ensuring the safety of both the mother as well as the child especially in the rising wake of maternal morbidities and neonatal complications.
It is imperative to note that there is no specific evidence prohibiting nursing practitioners from teaching women how to push during childbirth. In this case, most midwives and nursing practitioners assisting expectant mothers during childbirth instruct the women in labour to perform Valsalva Manoeuvre during the second stage of labour. In essence, I believe that the rationale used for pushing during childbirth is primarily drawn from the fact that pushing during childbirth speeds up the labour process, and as such, quickens the pace of delivery (Danford and Mercein, 2017). Nonetheless, this process of pushing placed both the mother as well as the baby in harms’ way, especially during neonatal complications.
According to my understanding of the childbirth setting, the midwife is supposed to guide the pregnant mother through the process of delivery by instructing her to push. In this case, the directions to push the baby out of the womb involve the Valsalva Manoeuvre, the open glottis pushing while breathing out (Hamilton, 2016). Normally, the manoeuvre relates to an attempted forceful exhalation against a closed airway, whereby the pregnant mother closes her mouth, pinches shut her nose while pressing out, as though she were blowing up a balloon. However, in this case, the mother is blowing out a baby from her womb. In most cases, this childbirth procedure is usually advocated for during childbearing.
Nonetheless, after conducting extensive research in the same field, as well as attending a biology lecture on parturition, I realised that it is not necessary for women to receive guidance from midwives and nursing practitioners during childbirth. The reason for this assertion is that women can easily push on their own without having someone to direct their pushing rhythms. However, the women may need assistance after delivery to detach the newborn baby from the umbilical code (Lemos, Dean and Andrade, 2011). This is a task that many cannot perform properly on their own, especially due to the excruciating labour pains that they would be experiencing at the time. Nevertheless, the above assertions do not confirm the perception that women are experts in childbirth, and as such, are still in dire need of assistance during childbirth, especially when considering the processes involved in undertaking either the spontaneous pushing or the Valsalva Manoeuvre during childbirth.
A thorough literature review analysis is essential in giving focus to a particular topic of discussion. In this particular case, I believed that by carrying out an in-depth literature review analysis I would be able to discover various key issues regarding my research topic. Furthermore, the literature review analysis is effective because it reviews all the secondary data published on the same topic of discussion (Roberts, 2003). Therefore, I began conducting an extensive literature review analysis on the topics of Valsalva Manoeuvre and Spontaneous pushing under restrained timing during the entire process of childbirth, all to maintain patient safety and wellbeing for both maternal and foetal health.
The first step to conducting a proper literature review analysis is to identify the keywords to use in the search process. In this case, there are two major keywords, as the research topic focuses on comparing two methods of childbirth procedures that are commonly used, as well as identifying the dangers involved in both procedures. As such, the first keyword was the Valsalva Manoeuvre technique, whereby I researched to find out its definition, how its undertaken, as well as how it is applied during childbirth, as well as taking note of the risks associated with using the procedure during the childbearing process (Roberts and Johnson, 2007). Similarly, the second keyword was the Spontaneous Pushing technique, whereby I researched to find out its definition, how its undertaken, as well as how it is applied during childbirth, in addition to unearthing the dangers associated with using the technique during childbearing procedures.
After identifying the keywords, the next step of the literature review involved identifying the right platforms or databases from which to conduct the research. The fact that the research topic was health-related meant that the databases identified for sources had to be health related. The reason for this assertion is because health-related journal and databases had a stronger appeal about the findings and recommendations as opposed to opinionated journals or reports from interest groups (Prins et al., 2011). In this regard, I paid particular preference to journals from NICE as well as NHS detailing the two childbirth procedures as well as the possible risks or dangers associated with either of the processes. Some of the databases that I used for my research included the Cochrane library, the Ovid Online databases, as well as the EBSCOhost database.
The choice of each database used during the literature review analysis was guided by the level of resourcefulness contained in each platform. For instance, my choice of the EBSCOhost database was particularly informed by the fact that it is an accented academic resource centre, and this research is primarily undertaken for academic purposes as opposed to medical purposes, I considered it wise to use the database. As for the case of Cochrane library, my choice was influenced by the wide range of sources that the library contained, and as such, this provided me with an extensive platform on which to conduct my literature review analysis (Simpson and James, 2005). The same case also applied to the online database. Searching through each database was not very difficult now that I had already identified the right keywords to use during my analysis. In fact, this made my work very easy as after typing in the keyword alongside the research topic, I got a list of numerous articles relating to it, some recent, and some old, which is selected at my pleasure, giving preference to the most recent articles nonetheless.
A Summary of the Research Paper
In essence, the entire process of conducting this research study focused on determining the constructs of maternal and foetal well-being with regards to the childbearing procedure used by pregnant mothers during childbirth. In this case, the research study focused on two primary childbearing procedures commonly used by midwives and nursing practitioners in assisting pregnant women to deliver during their second stage of labour. The techniques analysed in this case were the Valsalva Manoeuvre as well as the Spontaneous Pushing technique (Danford and Mercein, 2017). The focus in this analysis was to investigate how these procedures are usually undertaken during childbirth as well as establish the dangers associated with using these procedures during the process of childbirth, and whether any or both of them endangered maternal and foetal health.
The method used was the literature review analysis whereby secondary resources relating to the research topic and drawn from various websites and databases were reviewed to correlate the impact of each process on childbirth (Albers et al., 2005). The primary findings of the research study established that both spontaneous pushings as well as Valsalva manoeuvres had adverse negative effects to both the mother and the child, and as such, they were not appropriate in maintaining patient safety during the childbirth procedure, primarily about maternal health and foetal wellbeing. These findings were largely related to the pressure and distress that both methods caused to both mother and child during childbirth.
Looking back at this research study, I can confirm that it was a very informative as well as entertaining to undertake. In the first place, the research study focused on a new topic of discussion that I normally took for granted not knowing the dangers associated or involved with the use of each technique during childbirth. In essence, I can consider myself as being naïve in the process of childbirth, but after completing the research study, I could rate myself as an expert in the field. For one, I learnt how each procedure is performed as well as how the midwives have to direct the pregnant mothers to perform each procedure (Hamilton, 2016). Furthermore, I also learnt of the dangers associated with each procedure, and as such, I could advise a pregnant mother accordingly on the right approach to use during childbirth to ensure the patient safety of both mother and child. My reflection analysis adopted the Gibbs model of reflection to establish the level of transformation that I had undergone as a person following the completion of the research study.
In conclusion, I learnt from the research study that neither of the two childbirth procedures that were commonly used by midwives during childbirth was appropriate in maintaining maternal safety and foetal wellbeing. The reason for this assertion was because each method caused a significant amount of pressure in addition to constringing the free flow of oxygen from mother to child, and as such, placed both mother and child at grave risk. In essence, some of the risks involved in the adoption of either the spontaneous pushing technique or the Valsalva manoeuvre during childbirth include foetal distress, maternal distress, prolonging the period of labour, as well as perineal trauma among many other different forms of neonatal complications.
In this case, I concluded that the best birth procedure that women should be encouraged to use during childbirth is the instinctive pushing technique, as the procedure embraces natural vocalizations. As such, this approach in childbirth would be very effective in eliminating the challenges experienced by women during childbirth when using either of the two procedures discussed above. Furthermore, the fact that the instinctive pushing technique lacks any time restrictions imposed on the mother and her foetus also plays a fundamental role in promoting maternal safety and well being. In fact, awaiting the instinctive behaviour leads to the reduction of incidence in the urinary system, the pelvic floor as well as the perineal trauma. As such, I suppose these findings should be made public to facilitate midwives to understand critically the guidelines provided for the second stage of labour, all of which is undertaken with the primary goal of reducing the rate of maternal morbidities as well as the risk levels of neonatal complications.
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Danford, K. and Mercein, J., 2017. The Birth Process and Voice Training: The Glorious Chorus. Voice and Speech Review, 1-14
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Lemos, A., Dean, E. and Andrade, A.D.D., 2011. The Valsalva manoeuvre duration during labour expulsive stage: repercussions on the maternal and neonatal birth condition. Brazilian Journal of Physical Therapy, 15(1), pp.66-72.
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Simpson, K.R. and James, D.C., 2005. Effects of immediate versus delayed pushing during second‐stage labour on fetal well‐being: A randomised clinical trial. Nursing Research, 54(3), pp.149-157.