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A decrease in cesar...
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Akselsson, AnnaSophiahemmet Högskola
(author)
A decrease in cesarean sections and labor inductions among Swedish women by awareness of fetal movements with the Mindfetalness method
- Article/chapterEnglish2020
Publisher, publication year, extent ...
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2020-10-01
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Springer Science and Business Media LLC,2020
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LIBRIS-ID:oai:gup.ub.gu.se/297604
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https://gup.ub.gu.se/publication/297604URI
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https://doi.org/10.1186/s12884-020-03268-1DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3866URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:144859472URI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Background: Maternal perception of decreased fetal movements is commonly used to assess fetal well-being. However, there are different opinions on whether healthcare professionals should encourage maternal observation of fetal movements, as researchers claim that raising awareness increases unnecessary interventions, without improving perinatal health. We aimed to investigate whether cesarean sections and labor induction increase by raising women's awareness of fetal movements through Mindfetalness. Further, we aimed to study perinatal health after implementing Mindfetalness in maternity care. Methods: In a cluster randomized controlled trial, 67 maternity clinics were allocated to Mindfetalness or routine care. In the Mindfetalness group, midwives distributed a leaflet telling the women to focus on the character, strength and frequency of the fetal movements without counting each movement. The instruction was to do so for 15 min daily when the fetus was awake, from gestational week 28 until birth. In this sub-group analysis, we targeted women born in Sweden giving birth from 32 weeks' gestation. We applied the intention-to-treat principle. Results: The Mindfetalness group included 13,029 women and the Routine-care group 13,456 women. Women randomized to Mindfetalness had less cesarean sections (18.4% vs. 20.0%, RR 0.92, CI 0.87-0.97) and labor inductions (19.2% vs. 20.3%, RR 0.95, CI 0.90-0.99) compared to the women in the Routine-care group. Less babies were born small for gestational age (8.5% vs. 9.3%, RR 0.91, CI 0.85-0.99) in the Mindfetalness group. Women in the Mindfetalness group contacted healthcare due to decreased fetal movements to a higher extent than women in the Routine care group (7.8% vs. 43%, RR 1.79, CI 1.62-1.97). The differences remain after adjustment for potential confounders. Conclusions: Raising awareness about fetal movements through Mindfetalness decreased the rate of cesarean sections, labor inductions and small-for-gestational age babies.
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Lindgren, H.Karolinska Institutet
(author)
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Skokic, Viktor,1982Karolinska Institutet,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences(Swepub:gu)xskovi
(author)
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Rådestad, IngelaSophiahemmet Högskola(Swepub:shh)ingela.radestad
(author)
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Karolinska InstitutetSophiahemmet Högskola
(creator_code:org_t)
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In:BMC Pregnancy and Childbirth: Springer Science and Business Media LLC20:11471-2393
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