The Effects of Protocol Use for Admitting Women in Labour on Childbirth Method and Interventions: A RandomizedControlled Trial

Background: Over-diagnosis of dystocia may be due to early admission in labourleading to unnecessary interventions during labour and childbirth. The aim ofthis study was to determine the effects of protocol of admitting women in activelabour on childbirth method and interventions.Methods: This randomised clinical trial was conducted in a public hospital inMazandaran province in ۲۰۱۷. Two hundred nulliparous low-risk women wererandomly assigned into intervention and control groups. The participant womenwere admitted in the intervention group using the admission protocol anddirectly to the control group using routine admission. The admission criteria of theprotocol were: the presence of regular, painful contractions, the cervix at least ۴cm dilated and at least one of the following cues: cervix effaced, and spontaneousrupture of membranes, or “show”.Results: There were significant differences between the two intervention andcontrol groups in the number of Cesarean Sections. Two groups had a statisticallysignificant difference in amniotomy, augmentation by oxytocin, number of vaginalexaminations.Conclusions: Using a protocol for admission of low risk nulliparous women inactive labour contributed to reduction of the primary Cesarean Section rate andinterventions during childbirth. A risk assessment and using evidence informedguidelines in admission can contribute to reduce unsafe and harmful practicesand support normalisation of birth. This is essential for demedicalisation and auseful strategy for reducing primary CS.