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Birthing experience and quality of life after vacuum delivery and second‐stage caesarean section: a prospective cohort study in Uganda
Author(s) -
Nolens Barbara,
Akker Thomas,
Lule John,
Twinomuhangi Sulphine,
Roosmalen Jos,
Byamugisha Josaphat
Publication year - 2018
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13089
Subject(s) - medicine , vacuum extraction , caesarean section , prospective cohort study , quality of life (healthcare) , obstetrics , tertiary referral hospital , cohort , cohort study , pregnancy , gynecology , surgery , retrospective cohort study , nursing , genetics , biology
Abstract Objective To assess perceptions of women undergoing vacuum extraction or second‐stage caesarean section ( SSCS ) in a tertiary referral hospital in sub‐Saharan Africa. Methods Prospective cohort study, with six‐month follow‐up, of women who gave birth to a term singleton in cephalic presentation by vacuum extraction ( n = 289) or SSCS ( n = 357) between 25 November 2014, to 8 July 2015, in Mulago Hospital, Uganda. Excluded were women who had failed vacuum extraction, severe birth complications and those whose babies had died. Outcome measures were birthing experience satisfaction, physical component summary ( PCS ) and mental component summary ( MCS ) of the SF ‐12 quality‐of‐life questionnaire, pain scores and dyspareunia. Results One day after vacuum extraction, 63.7% (181/284) of women were feeling well vs . 48.1% (167/347) after SSCS ( OR 1.89; 95% CI 1.37–2.61) and mean pain sores were 2.70 vs . 3.87 ( P < 0.001). In both groups, >90% of women were satisfied with their birthing experience. At six weeks, in vacuum extraction vs . SSCS , mean pain sores were 0.40 vs . 0.89 ( P < 0.001); mean PCS was 48.67 vs . 44.03 ( P < 0.001); mean MCS was 52.80 vs . 51.23 ( P = 0.203); 40% (70/175) vs . 28.3% (70/247) of women had resumed sexual intercourse ( OR 1.69; 95% CI 1.12–2.54) and 21.4% (15/70) vs . 28.6% (20/70) had dyspareunia ( OR 0.68; 95% CI 0.32–1.47). No differences were found at six months after birth. Conclusion One day and six weeks after birth, outcomes were better in women who had vacuum extraction. At six months, outcomes were similar. To promote quick recovery, vacuum extraction should be the first intervention considered in the second stage of labour.