You can use your existing Medical Independent, MediLearning or PharmacistCPD account to log in. is Ireland's only investigative medical news website for doctors, healthcare professionals and anyone with an interest in health issues.

Established in 2010, along with its sister publication The Medical Independent, our stated aim is to investigate and analyse the major issues affecting healthcare and the medical profession in Ireland. The Medical Independent has won a number of awards for its investigative journalism, and its stories are frequently picked up by national digital, broadcast and print media. The Medical Independent is published by GreenCross Publishing.

Address: Top Floor, 111 Rathmines Road Lr, Dublin 6

Tel: 353 (01) 441 0024

GreenCross Publishing is owned by Graham Cooke.

The benefits of registering: only registered users:
  • receive the ecCopy two days prior to the printed edition.
  • have automatic access to our free CPD sites.
  • can partake in our online MCQs.
  • can enter our online sports quiz.

Sign up now for ease of access to The Medical Independent, Ireland’s most frequently published medical newspaper, delivering award-winning news and investigative reporting.

Download the new Mindo app for both IOS & Android.

  • Get notified when a story goes live
  • Access Premium Content
  • Read Offline

You are reading 1 of 2 free-access articles allowed for 30 days

Less than 1% of births in nulliparous women are ‘practically perfect’ – IMJ study

By Mindo - 10th May 2018 | 3 views

The authors defined a “practically perfect” birth as a spontaneous labour without intervention, an intact perineum and a positive neonatal outcome. The study poses the question whether the “unrealistic expectations of labour in first time mothers can present challenges to physicians and midwives”.

To extract the perfect births, deliveries <37 weeks, induction/pre-labour Caesarean Section (CS), Artificial Rupture of Membranes (ARM), oxytocin, fetal blood sample, emergency CS/instrumental deliveries, perineal damage and suboptimal Apgar scores were all excluded. The focus of the study was on the 8292 nulliparous labours.

Among 18,698, there were 8292 nulliparous women of whom 7,616 delivered after 37 weeks. Of these, 4,171 went into spontaneous labour, while 2,753 were induced. Some 692 had a caesarean section as a primary procedure. Some 2,111 women were noted to have an artificial rupture of membranes in labour and 857 received oxytocin. After excluding these, there were 1,203 remaining. Some 172 women had a fetal blood sample taken, leaving 1,031.

Of the 1,031 women who had a spontaneous labour without any of the interventions mentioned above, 57 had an emergency caesarean section, 86 had a ventouse delivery, 33 had a forceps delivery, two were spontaneous breech deliveries and five were born before arrival to hospital. That excluded a total of 183, leaving 848 ‘practically perfect’ births.

All tears and episiotomies were excluded which left 68 with an intact perineum. Out of these 68, two were extracted based on suboptimal Apgar scores. This left 66 ‘perfect’ deliveries or 0.8 per cent of all nulliparous mothers who had a ‘practically perfect’ birth. Out of the 66 ‘perfect’ deliveries, 15 were noted to have opted for community midwife care. When those who went with community midwife care and the standard obstetric care group were separated, the rate of ‘practically perfect’ births was 3 per cent in the midwife group compared to 0.7 per cent in the obstetric group.

Leave a Reply

Latest Issue
The Medical Independent – 24 June 2021

You need to be logged in to access this content. Please login or sign up using the links below.

Most Read