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 |