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Table 2 The policies guiding mothers’ care during the second stage of labor

From: A cross-sectional survey of policies guiding second stage labor in urban Japanese hospitals, clinics and midwifery birth centers

Variables Hospitals n=118 Clinics n=66 Midwifery Birth Centers n=71 p
Perineal massage education during the second stage of labor     
 almost all cases 10 (8.5) 5 (7.6) 15 (21.1) .056
 depending on the case 39 (33.1) 19 (28.8) 22 (31.0)  
 not implemented 69 (58.5) 42 (63.6) 34 (47.9)  
 not stated 0 0 0  
Active birth during the second stage of labor     
 implemented 65 (56.0) 21 (31.8) 68 (100) <.001
 not implemented 51 (44.0) 45 (68.2) 0  
 not stated 2 0 3  
Active birth at delivery     
 implemented 36 (31.0) 11 (16.7) 61 (89.7) <.001
 not implemented 80 (69.0) 55 (83.3) 7 (10.3)  
 not stated 2 0 3  
Water birth     
 implemented 1 (0.9) 2 (3.0) 24 (34.3) <.001
 not implemented 115 (99.1) 64 (97.0) 46 (65.7)  
 not stated 2 0 1  
Applying warm compress to the perineum     
 almost all cases 2 (1.7) 0 8 (11.4) <.001
 depending on the case 30 (25.6) 13 (20.0) 35 (50.0)  
 not implemented 85 (72.6) 52 (80.0) 27 (38.6)  
 not stated 1 1 1  
Valsalva during pushing     
 almost all cases 44 (37.9) 33 (50.0) 7 (10.0) <.001
 depending on the case 69 (59.5) 30 (45.5) 47 (67.1)  
 not implemented 3 (2.6) 3 (4.5) 16 (22.9)  
 not stated 2 0 1  
Hands-on technique to support fetal expulsion     
 almost all cases 104 (89.7) 57 (87.7) 38 (54.3) <.001
 depending on the case 11 (9.5) 7 (10.8) 24 (34.3)  
 not implemented 1 (0.9) 1 (1.5) 8 (11.4)  
 not stated 2 1 1  
Perineal disinfection     
 implemented 110 (94.0) 56 (84.8) 51 (72.9) <.001
 not implemented 7 (6.0) 10 (15.2) 19 (27.1)  
 not stated 1 0 1  
Episiotomy for primiparas     
 almost all cases 24 (20.7) 16 (24.6) 1 (1.5) <.001
 depending on the case 91 (78.4) 43 (66.2) 3 (4.4)  
 not implemented 1 (0.9) 6 (9.2) 64 (94.1)  
 not stated 2 1 3  
Episiotomy for multiparas     
 almost all cases 2 (1.7) 0 0 <.001
 depending on the case 109 (94.0) 57 (87.7) 0  
 not implemented 5 (4.3) 8 (12.3) 68 (100)  
 not stated 2 1 3  
Fundal pressure during the second stage of labor     
 almost all cases 1 (0.9) 0 0 <.001
 depending on the case 106 (91.4) 54 (83.1) 22 (32.4)  
 not implemented 9 (7.8) 11 (16.9) 46 (67.6)  
 not stated 2 1 3  
Hands and knees position for correcting fetal abnormal rotation     
 almost all cases 10 (8.6) 5 (7.9) 16 (23.2) <.001
 depending on the case 63 (54.3) 21 (33.3) 34 (49.3)  
 not implemented 43 (37.1) 37 (58.7) 19 (27.5)  
 not stated 2 3 2