Petrocnik et al talks about the professionalization of midwifery. The professional status of midwifery is based on specific expertise unknown to lay people and other professional groups. Another ...important aspect of this professionalism is a strong sense of affiliation to the professional discipline, which stems from a shared past and pride in its historical achievements. It is also worth mentioning that midwives are proud of the tradition midwifery education has had in Slovenia.
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The placenta is a temporary organ, essential for the survival, growth and development of the foetus. It is delivered during the third stage of labour. The purpose of this study was to gain ...information regarding the management of the third stage of labour in Slovenian maternity hospitals, including midwives' competences within this scope of practice. Descriptive quantitative method was used with a survey questionnaire as a research instrument. Convenience sample included all 14 Slovenian maternity hospitals. The data were gathered during May and June 2012. The analysis of data was performed with SPSS 17 programme. The response rate to the survey was 86%. Two thirds of the respondents (67 %) report that the third stage of labour is usually actively managed. In general, the placenta is delivered by a midwife (83 %), however, the placenta is not examined only by a midwife, it is also checked by a doctor (83 %). The majority of midwives (83 %) feel professionally confident to examine the placenta autonomously. The final birth outcome is the responsibility of a doctor. Therefore, in the majority of cases, midwives are not completely independent, despite their competences and qualifications for the management of uncomplicated deliveries.
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Prelec et al present a prospective observational case-control study that was carried out in Ljubljana Maternity Hospital in the period May-August 2013 to compare birth, maternal and newborn outcomes ...in the midwife led unit and the obstetric unit to ascertain whether a midwife led unit reduced medicalization of childbirth. The sample comprised 497 laboring women; 154 who attended the midwife led and 343 who attended in the obstetric unit, both matching the same inclusion criteria: low risk primiparous; singleton term pregnancies, normal foetal heart beat, cephalic presentation; spontaneous onset of labor. The primary outcome was the caesarean section rate. The study revealed that in the midwife led unit fewer medical interventions were used.
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Planned home birth in Slovenia—Are we ready? Takač, Iztok; Belak, Urška; Gorjup, Denis ...
The International journal of health planning and management,
October/December 2019, 2019-Oct, 2019-10-00, 20191001, Volume:
34, Issue:
4
Journal Article
Peer reviewed
Summary
Nowadays, women want a more intimate and familiar atmosphere during labour, which results in increased planned home birth rates. Every woman has the autonomy to decide where she will give ...birth; however, it is important that she is informed of risks and advantages beforehand. Home births can be distinguished between planned and unplanned home births. Planned home births can be conducted by professional birth attendants (licensed midwives) or birth assistants (doulas, etc). The rates of Slovenian women who decided to deliver at home are increasing year by year.
Researches on home births still present discordant data about home birth safety. Their findings have shown that the main advantage of home birth is a spontaneous birth without medical interventions, especially in multiparous low‐risk women. The main disadvantage, however, is a higher risk for neonatal death, in particular on occurrence of complications requiring a transfer to hospital and surgical intervention. Global guidelines emphasize careful selection of candidates suitable for home birth, well‐informed pregnant women, education of birth attendants, and strict formation of transfer indications.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
16.
Pritisk na fundus med drugo porodno dobo Jerneja Štinek; Ana Polona Mivšek; Anita Prelec
Obzornik zdravstvene nege,
03/2013, Volume:
47, Issue:
1
Journal Article
Though the role of fundal pressure is still understudied and remains controversial, it is frequently used as an obstetric technique to assist spontaneous vaginal delivery and avoid prolonged second ...stage of labour. The purpose of the article is to identify the prone factors of the use of uterine fundal pressure maneuver and to evaluate its obstetrical outcomes. The literature review and meta-synthesis of scientific studies were performed using the COBIB.SI and databases of Medline, CINAHL, ScienceDirect, PubMed, Cochrane Collaboration, Wiley Online Library in Springer Link with the following keywords and phrases: fundal pressure, second stage of labour, shoulder dystocia, uterine rupture. 152 pertinent articles were found and seven studies were analysed. Included in the review were the papers published from 1996 till 2011, with the entire text available online, either in English or Slovene. All the texts were related to the effectiveness and safety of the manoeuvre. The studies were evaluated and analysed for their methodological quality and on the basis of the sample, research parameters and results. There is little evidence to demonstrate that the use of fundal pressure is effective to improve maternal and/or neonatal outcomes. Moreover, there may be some adverse maternal/fetal effects, such as brachial plexus injuries (the baby), rupture of uterus or broken ribs (the mother) and increased possibility of serious perineal ruptures. There is also a scarcity of literature substantiating that fundal pressure decreases the duration of the second stage of labour. It is commendable that accurate and thorough documentation be kept of all the manouvers performed in Slovenian hospitals. It is necessary to determine the incidence rate of the manouver and evaluate its effect on maternal and neonatal outcomes and whether fundal pressure benefits counterbalance the harms. Evidence-based clinical practice guidelines could thus be developed for future practice and midwives' responsibility.
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