Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth

Background Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at hom...
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Autor*in:	Edqvist, Malin [verfasserIn] Blix, Ellen Hegaard, Hanne K. Ólafsdottir, Olöf Ásta Hildingsson, Ingegerd Ingversen, Karen Mollberg, Margareta Lindgren, Helena

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2016

Schlagwörter:	Home birth Birth positions Severe perineal trauma Perineal injuries Episiotomy Waterbirth

Anmerkung:	© The Author(s). 2016

Übergeordnetes Werk:	Enthalten in: BMC pregnancy and childbirth - London : BioMed Central, 2001, 16(2016), 1 vom: 29. Juli
Übergeordnetes Werk:	volume:16 ; year:2016 ; number:1 ; day:29 ; month:07

Links:	Volltext

DOI / URN:	10.1186/s12884-016-0990-0

Katalog-ID:	SPR027584518

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520			\|a Background Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86–1.21) or SPT (OR 0.68; CI 95 % 0.26–1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10–0.54). Conclusion A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. Flexible sacrum positions were associated with fewer episiotomies.
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allfields	10.1186/s12884-016-0990-0 doi (DE-627)SPR027584518 (SPR)s12884-016-0990-0-e DE-627 ger DE-627 rakwb eng Edqvist, Malin verfasserin aut Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2016 Background Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86–1.21) or SPT (OR 0.68; CI 95 % 0.26–1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10–0.54). Conclusion A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. Flexible sacrum positions were associated with fewer episiotomies. Home birth (dpeaa)DE-He213 Birth positions (dpeaa)DE-He213 Severe perineal trauma (dpeaa)DE-He213 Perineal injuries (dpeaa)DE-He213 Episiotomy (dpeaa)DE-He213 Waterbirth (dpeaa)DE-He213 Blix, Ellen (orcid)0000-0001-7971-4580 aut Hegaard, Hanne K. aut Ólafsdottir, Olöf Ásta aut Hildingsson, Ingegerd aut Ingversen, Karen aut Mollberg, Margareta aut Lindgren, Helena aut Enthalten in BMC pregnancy and childbirth London : BioMed Central, 2001 16(2016), 1 vom: 29. Juli (DE-627)335489087 (DE-600)2059869-5 1471-2393 nnns volume:16 year:2016 number:1 day:29 month:07 https://dx.doi.org/10.1186/s12884-016-0990-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 29 07
spelling	10.1186/s12884-016-0990-0 doi (DE-627)SPR027584518 (SPR)s12884-016-0990-0-e DE-627 ger DE-627 rakwb eng Edqvist, Malin verfasserin aut Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2016 Background Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86–1.21) or SPT (OR 0.68; CI 95 % 0.26–1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10–0.54). Conclusion A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. Flexible sacrum positions were associated with fewer episiotomies. Home birth (dpeaa)DE-He213 Birth positions (dpeaa)DE-He213 Severe perineal trauma (dpeaa)DE-He213 Perineal injuries (dpeaa)DE-He213 Episiotomy (dpeaa)DE-He213 Waterbirth (dpeaa)DE-He213 Blix, Ellen (orcid)0000-0001-7971-4580 aut Hegaard, Hanne K. aut Ólafsdottir, Olöf Ásta aut Hildingsson, Ingegerd aut Ingversen, Karen aut Mollberg, Margareta aut Lindgren, Helena aut Enthalten in BMC pregnancy and childbirth London : BioMed Central, 2001 16(2016), 1 vom: 29. Juli (DE-627)335489087 (DE-600)2059869-5 1471-2393 nnns volume:16 year:2016 number:1 day:29 month:07 https://dx.doi.org/10.1186/s12884-016-0990-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 29 07
allfields_unstemmed	10.1186/s12884-016-0990-0 doi (DE-627)SPR027584518 (SPR)s12884-016-0990-0-e DE-627 ger DE-627 rakwb eng Edqvist, Malin verfasserin aut Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2016 Background Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86–1.21) or SPT (OR 0.68; CI 95 % 0.26–1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10–0.54). Conclusion A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. Flexible sacrum positions were associated with fewer episiotomies. Home birth (dpeaa)DE-He213 Birth positions (dpeaa)DE-He213 Severe perineal trauma (dpeaa)DE-He213 Perineal injuries (dpeaa)DE-He213 Episiotomy (dpeaa)DE-He213 Waterbirth (dpeaa)DE-He213 Blix, Ellen (orcid)0000-0001-7971-4580 aut Hegaard, Hanne K. aut Ólafsdottir, Olöf Ásta aut Hildingsson, Ingegerd aut Ingversen, Karen aut Mollberg, Margareta aut Lindgren, Helena aut Enthalten in BMC pregnancy and childbirth London : BioMed Central, 2001 16(2016), 1 vom: 29. Juli (DE-627)335489087 (DE-600)2059869-5 1471-2393 nnns volume:16 year:2016 number:1 day:29 month:07 https://dx.doi.org/10.1186/s12884-016-0990-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 29 07
allfieldsGer	10.1186/s12884-016-0990-0 doi (DE-627)SPR027584518 (SPR)s12884-016-0990-0-e DE-627 ger DE-627 rakwb eng Edqvist, Malin verfasserin aut Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2016 Background Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86–1.21) or SPT (OR 0.68; CI 95 % 0.26–1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10–0.54). Conclusion A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. Flexible sacrum positions were associated with fewer episiotomies. Home birth (dpeaa)DE-He213 Birth positions (dpeaa)DE-He213 Severe perineal trauma (dpeaa)DE-He213 Perineal injuries (dpeaa)DE-He213 Episiotomy (dpeaa)DE-He213 Waterbirth (dpeaa)DE-He213 Blix, Ellen (orcid)0000-0001-7971-4580 aut Hegaard, Hanne K. aut Ólafsdottir, Olöf Ásta aut Hildingsson, Ingegerd aut Ingversen, Karen aut Mollberg, Margareta aut Lindgren, Helena aut Enthalten in BMC pregnancy and childbirth London : BioMed Central, 2001 16(2016), 1 vom: 29. Juli (DE-627)335489087 (DE-600)2059869-5 1471-2393 nnns volume:16 year:2016 number:1 day:29 month:07 https://dx.doi.org/10.1186/s12884-016-0990-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 29 07
allfieldsSound	10.1186/s12884-016-0990-0 doi (DE-627)SPR027584518 (SPR)s12884-016-0990-0-e DE-627 ger DE-627 rakwb eng Edqvist, Malin verfasserin aut Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2016 Background Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86–1.21) or SPT (OR 0.68; CI 95 % 0.26–1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10–0.54). Conclusion A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. Flexible sacrum positions were associated with fewer episiotomies. Home birth (dpeaa)DE-He213 Birth positions (dpeaa)DE-He213 Severe perineal trauma (dpeaa)DE-He213 Perineal injuries (dpeaa)DE-He213 Episiotomy (dpeaa)DE-He213 Waterbirth (dpeaa)DE-He213 Blix, Ellen (orcid)0000-0001-7971-4580 aut Hegaard, Hanne K. aut Ólafsdottir, Olöf Ásta aut Hildingsson, Ingegerd aut Ingversen, Karen aut Mollberg, Margareta aut Lindgren, Helena aut Enthalten in BMC pregnancy and childbirth London : BioMed Central, 2001 16(2016), 1 vom: 29. Juli (DE-627)335489087 (DE-600)2059869-5 1471-2393 nnns volume:16 year:2016 number:1 day:29 month:07 https://dx.doi.org/10.1186/s12884-016-0990-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 29 07
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source	Enthalten in BMC pregnancy and childbirth 16(2016), 1 vom: 29. Juli volume:16 year:2016 number:1 day:29 month:07
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author	Edqvist, Malin
spellingShingle	Edqvist, Malin misc Home birth misc Birth positions misc Severe perineal trauma misc Perineal injuries misc Episiotomy misc Waterbirth Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth
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topic_title	Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth Home birth (dpeaa)DE-He213 Birth positions (dpeaa)DE-He213 Severe perineal trauma (dpeaa)DE-He213 Perineal injuries (dpeaa)DE-He213 Episiotomy (dpeaa)DE-He213 Waterbirth (dpeaa)DE-He213
topic	misc Home birth misc Birth positions misc Severe perineal trauma misc Perineal injuries misc Episiotomy misc Waterbirth
topic_unstemmed	misc Home birth misc Birth positions misc Severe perineal trauma misc Perineal injuries misc Episiotomy misc Waterbirth
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title_full	Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth
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title_sort	perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth
title_auth	Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth
abstract	Background Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86–1.21) or SPT (OR 0.68; CI 95 % 0.26–1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10–0.54). Conclusion A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. Flexible sacrum positions were associated with fewer episiotomies. © The Author(s). 2016
abstractGer	Background Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86–1.21) or SPT (OR 0.68; CI 95 % 0.26–1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10–0.54). Conclusion A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. Flexible sacrum positions were associated with fewer episiotomies. © The Author(s). 2016
abstract_unstemmed	Background Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86–1.21) or SPT (OR 0.68; CI 95 % 0.26–1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10–0.54). Conclusion A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. Flexible sacrum positions were associated with fewer episiotomies. © The Author(s). 2016
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title_short	Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth
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The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86–1.21) or SPT (OR 0.68; CI 95 % 0.26–1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10–0.54). Conclusion A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. 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Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth

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