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Relaxation may aid natural birth

Thursday July 28th, 2011

Relaxation training and better birth preparation may help reduce the rising rate of Caesarean section births, according to an analysis published today.

A new Cochrane review has looked at the evidence for different methods of reducing unnecessary caesareans.

Caesareans can be lifesaving for both mother and baby, but they are not without risk and should not be done when not necessary, say Dr Suthit Khunpradit of Lamphun Hospital, Thailand, and colleagues.

The team looked at 16 studies on the role of "non-clinical" interventions such as prenatal education on reducing the caesarean rate.

A nurse-led relaxation training programme for women with a fear or anxiety of childbirth, and birth preparation sessions, were both effective. But the numbers of women involved were small.

The researchers found no clear evidence that prenatal education and support programmes, computer patient decision-aids, decision-aid booklets and intensive group therapy are effective.

Ten studies targeted health professionals. Mandatory second opinion was effective in one trial but not all, but there was "insufficient evidence that audit and feedback, training of public health nurses, insurance reform, external peer review and legislative changes are effective".

The authors write: "For low-risk pregnancies, nurse-led relaxation classes and birth preparation classes for mothers may decrease the number of caesarean sections.

"Implementation of guidelines with mandatory second opinion, implementation of guidelines with support from local opinion leaders, and audit and feedback given to the individual provider may decrease caesarean sections."

Dr Khunpradit added: "In some settings, maternal mortality associated with caesarean section has been reported to be two to four times greater than that associated with vaginal birth.

"There is a clear need to halt the escalating use of Caesarean sections, and from the studies published so far the strategies that had clearest evidence of reducing the proportion of Caesarean sections were those that focused on the clinicians."

Khunpradit, S. et al. Non-clinical interventions for reducing unnecessary caesarean section. Cochrane Database of Systematic Reviews 2011, Issue 6.

Tags: Asia | Childbirth and Pregnancy | Nursing & Midwifery | Women’s Health & Gynaecology

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