Table 2.
Classification of the reported practices of the eight governmental hospitals according to Enkin et al.
Practice | Number of hospitals reporting routine use | ||
---|---|---|---|
Forms of care likely to be ineffective or harmful | |||
Enema | 2 | ||
Pubic shaving | 4 | ||
Lithotomy position during 2nd stage of labor | 8 | ||
Liberal or routine use of episiotomy | 6, particularly for primigravidae | ||
Forms of care unlikely to be beneficial | |||
Withholding food and drink | 2 | ||
Routine intravenous infusion | 3 | ||
Routine suctioning of the newborn | 3 | ||
Beneficial forms of care | |||
Prophylactic oxytocics in 3rd stage | 8 | ||
Active vs. expectant management of 3rd stage | 8 | ||
Unrestricted breastfeeding | 8 | ||
Forms of care likely to be beneficial, although not established by randomized trials | |||
Midwifery care for low-risk women | 8 | ||
Presence of a companion for labor and birth | 0 | ||
Freedom of movement and choice of position in labor | 8 | ||
Non-pharmacological methods of pain relief | 7 | ||
Keeping newborn babies warm | 8, dry and put on heated resuscitation table | ||
Encouraging early mother—infant contact and breastfeeding | 8 | ||
Prophylactic vitamin K to baby | 7 | ||
Forms of care with a trade-off between beneficial and adverse effects | |||
Narcotics to relieve pain in labor | 7 use pethidine frequently | ||
Epidural analgesia to relieve pain in labor | 6 do not provide epidural analgesia; 2 provide it for a small # of cases | ||
Oxytocin for augmentation of labor | 5 reported augmentation with oxytocin in over 50% of the cases | ||
Continuous electronic monitoring versus intermittent auscultation during labor | All facilities reported using intermittent auscultation and having at least one monitor. | ||
Only three hospitals had a fetal stethoscope |