None listed
Conditions
Brief summary
This study aims to determine whether primigravida women who are experiencing post-date pregnancy (41 weeks gestation) are more likely to experience spontaneous onset of labour using specific acupressure points than women receiving usual antenatal care only. The secondary aim is to explore the women’s experience on the care received and being randomised. For women allocated to the acupressure group,information will be collected on their compliance with intervention protocol and satisfaction with the use of acupressure. This study will add to the body of knowledge and has the potential to address the strategies and targets set by NSW Health Policy Directive Towards Normal Birth, by increasing the number of women commencing labour spontanously and reducing the rate of medical interventions (labour induction).
Interventions
Usual care and acpuressure points. The acupressure protocol has been developed by the Chief Investigator Lyndall Mollart based on the literature review and in consultation with Debra Betts, an internationally recognised leader in acupuncture and acupressure (Betts 2003).
At 41 weeks gestation and randomised to the invention (acupressure group), the woman and partner/support person will be shown the three bilateral points: SP6 [lower leg], LI4 [hand], GB21 [shoulder]. They will be instructed on
Usual care and acpuressure points. The acupressure protocol has been developed by the Chief Investigator Lyndall Mollart based on the literature review and in consultation with Debra Betts, an internationally recognised leader in acupuncture and acupressure (Betts 2003). At 41 weeks gestation and randomised to the invention (acupressure group), the woman and partner/support person will be shown the three bilateral points: SP6 [lower leg], LI4 [hand], GB21 [shoulder]. They will be instructed on how to apply sustained bilateral pressure using thumb or finger for: 2 minutes on point SP6 [lower leg] followed by 2 minutes on LI4 [hand] every 2 hours during the day; and 2 minutes on point GB21 [shoulder point] twice a day (morning and evening) daily. The women will be instructed to continue to use accupressure until onset of labour The women will also receive a written instruction sheet with diagrams showing the location of the points and description on the usage i.e. timing and frequency. A diary sheet to keep a daily record on the frequency and use of the points will be provided to the women. The research assistant will contact the woman one to two days after the 41 week antenatal visit to discuss the use of the acupressure points and if further education is required. Usual antenatal care at 40 weeks and 10 days: The participant will be advised of her next clinic/ Day Assessment Unit (DAU) appointment at approximately 40wks+10 days (+/- 2 days) for assessment for medical induction and date given for medical induction (by 40 weeks and 14 days). Maternal and fetal assessment includes abdominal palpation, vaginal examination to determine Bishop score, and CTG (fetal electronic monitoring).
Sponsors
NSW Ministry of Health
Study design
Allocation
Randomised controlled trial
Intervention model
Factorial
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 44 Years
Healthy volunteers
Yes
Inclusion criteria
Patients who meet the study inclusion criteria will be recruited from maternity services, based at Gosford and Wyong Hospitals. All eligible women receiving care at the study sites will be invited to participate. The inclusion criteria are: primigravid women of gestation at 41 weeks gestation or greater, with a singleton pregnancy; fetus in a cephalic presentation; English speaking; age of 18 years and over; receiving antenatal care with a midwifery model of care (as NSW PD 2010_022 Maternity- National Midwifery Guidelines for Consultation and Referral).
Exclusion criteria
women experiencing regular uterine contractions (established labour); Contra-indication to induction of labour or vaginal birth; Women do not speak or read English will be unfairly discriminated against in the study, in the absence of a budget for adequate translation services for the written materials that are designed to facilitate informed consent. Regardless of the model of care that women access at Gosford maternity, service interpreter services are made available to them but this cannot always be guaranteed; Women with an intellectual or mental impairment may be disadvantaged in the process of giving informed consent. These women will need to access extra services from the mental health team at Gosford Hospital in order to negotiate decision making regarding the study and randomisation; Women who are highly dependent on medical care would require specialist medical/obstetric consultation and will usually have medical intervention prior to 41 weeks gestation; Women who are currently using Acupressure for post dates
Outcome results
None listed