irish medical journal

The percentage of 'perfect' births in first-time mothers is less than 1% - study

The study looked at over 8,000 pregnancies in women who hadn’t given birth before.

THE RATE OF “practically perfect” births among Irish women is estimated to be less than 1%, according to a study published in the Irish Medical Journal today.

The study looked at over 18,000 instances of labour at the National Maternity Hospital over a 2-year period. It found that the number of “practically perfect” births in women who hadn’t given birth before to be at 0.8%.

The authors defined  a “practically perfect” birth as a delivery after 37 weeks, a spontaneous labour without intervention, an intact perineum and a positive neonatal outcome.

The study poses the questions whether the unrealistic expectations of labour in first time mothers can present challenges to physicians and midwives.

These were the exclusion criteria in the study: delivery in under 37 weeks; induced/pre-labour Caesarean section; artificial rupture of membranes; Oxytocin; fetal blood sample; emergency Caesarean section/forceps delivery/ventouse delivery; perineal outcome: first degree tear +/- sutures, second degree tear +/- sutures, 3rd degree tear, episiotomy +/- sphincter damage, labial tears; neonatal outcome: apgars of <9 at 1 or 5 minutes.


shutterstock_694046602 (1) Shutterstock / HII_Tokyo Shutterstock / HII_Tokyo / HII_Tokyo

Among 18,698 there were 8,292 nulliparous women, or women who hadn’t given birth before. 7,616 of these women delivered after 37 weeks.

Of these, 4,171 went into spontaneous labour, while 2,753 were induced. 692 had a Caesarean section as a primary procedure. 2,111 women were noted to have an artificial rupture of membranes in labour and 857 received oxytocin. After excluding these, there were 1,203 remaining. 172 women had a fetal blood sample taken, leaving 1,031.

Of the 1,031 women who had a spontaneous labour without any of the interventions mentioned above, 57 had an emergency Caesarean section, 86 had a ventouse delivery, 33 had a forceps delivery, 2 were spontaneous breech deliveries and 5 were born before arrival to hospital.

That excluded a total of 183 leaving 848 “practically perfect” births.

Limitations of the study

The study included those who received epidurals during their labour. Neither antenatal nor postnatal complications were included; this is a potential limitation to the study.

This study objectively defined a practically perfect birth resulting in stringent exclusion criteria. No input from the mothers themselves was accounted which is both a limitation and an area for future research.

The authors conclude the study by asking whether imparting this information to first-time mothers evoke fear of labour or provide realistic expectations of what to expect.

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