Journal of Sexual and Reproductive Healthcare

Paper: Parents’ experiences of an instrumental vaginal birth findings from a regional study in Sweden
Paper authors: Hildingsson I, Karlstrom A, Nystedt A
Paper ref: (2013): 4(1) 3-8

This survey of parents in Sweden focuses on identifying common factors associated with assisted vaginal delivery, and on parents’ experiences of birth as a result. Over 2,000 parents, split almost equally between men and women, were recruited during routine antenatal care.

The study confirms that instrumental or assisted vaginal delivery is associated with regional analgesia, augmentation with oxytocinon and longer labours, but also gives some new information with regard to parents’ experiences.

Particularly useful are the partner experiences, as it is now regarded as normal that they will be present at the time of labour and delivery, and the experience of birth is shared in the relationship. Partners in this study reported a sense of panic and loss of control at the time of assisted delivery.

In the study, the prevalence of instrumental vaginal delivery was nine percent, roughly in keeping with Sweden’s national average. Mothers who experienced an assisted vaginal delivery reported more negative birth experiences than their spontaneous-vaginal-delivery counterparts, and reported more concerns about the long-term impact of delivery on the future health of the child. The latter is already well known, particularly in association with vacuum delivery.

The authors highlight the importance of good communication as part of the care given in labour, not just for the mother, but also her partner, for whom assisted delivery may also be a distressing experience.

The study authors note some shortcomings: the exclusion of non-Swedish speakers, the limited geographical area of the study and the potential impact on whether or not its findings can be generalised. Whilst the study has a fairly large sample size, the confidence intervals reported are wide.

The experience of birth is obviously a subjective one, and what professionals regard as a successful delivery may not always be perceived in the same way by the mother. Being aware of this, and the negative experiences associated with assisted birth, could be helpful in streamlining the debriefing process, and including the partner in the debriefing process should be considered good practice.

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