{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T22:27:55Z","timestamp":1785277675205,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2006,5,24]],"date-time":"2006-05-24T00:00:00Z","timestamp":1148428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth"],"published-print":{"date-parts":[[2006,6]]},"abstract":"<jats:p><jats:bold>Abstract:\u2002<\/jats:bold>  <jats:bold>Objective:<\/jats:bold>\n          <jats:italic>Episiotomy rates are declining in the United States. In settings with very low rates, evidence remains sparse on how best to facilitate birth without lacerations. The purpose of this investigation was to identify maternal and clinical factors related to genital tract trauma in normal, spontaneous vaginal births<\/jats:italic>. <jats:bold>Methods:<\/jats:bold><jats:italic>Data from a randomized clinical trial of perineal management techniques were used to address the study objective. Healthy women had spontaneous births with certified nurse\u2010midwives in a medical center setting. Proportions of maternal characteristics and intrapartum variables were compared in women who did and did not sustain sufficient trauma to warrant suturing, according to parity (first vaginal births versus others). Logistic regression using a backward elimination strategy was used to identify predictors of obstetric trauma<\/jats:italic>. <jats:bold>Results<\/jats:bold>: <jats:italic>In women who had a first vaginal birth, risk factors for trauma were maternal education of high school or beyond, Valsalva pushing, and infant birthweight. Risk factors in women having a second or higher vaginal birth were prior sutured trauma and infant birthweight. For all mothers, delivery of the infant's head between contractions was associated with reduced trauma to the genital tract<\/jats:italic>. <jats:bold>Conclusions:<\/jats:bold><jats:italic>Delivery technique that is unrushed and controlled may help reduce obstetric trauma in normal, spontaneous vaginal births. (BIRTH 33:2 June 2006)<\/jats:italic><\/jats:p>","DOI":"10.1111\/j.0730-7659.2006.00085.x","type":"journal-article","created":{"date-parts":[[2006,5,24]],"date-time":"2006-05-24T10:35:29Z","timestamp":1148466929000},"page":"94-100","source":"Crossref","is-referenced-by-count":82,"title":["Factors Related to Genital Tract Trauma in Normal Spontaneous Vaginal Births"],"prefix":"10.1111","volume":"33","author":[{"given":"Leah L.","family":"Albers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay D.","family":"Sedler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Bedrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dusty","family":"Teaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Peralta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,5,24]]},"reference":[{"issue":"2","key":"e_1_2_6_2_2","first-page":"15","article-title":"Births: Final data for 2003","volume":"54","author":"Martin JA","year":"2005","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_6_3_2","volume-title":"2002 National Hospital Discharge Survey","author":"DeFrances CJ","year":"2004"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536x.2001.00152.x"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536X.2002.00182.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.17.2141"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.1998.t01-2-.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536x.1999.00011.x"},{"key":"e_1_2_6_9_2","first-page":"333","article-title":"The association between perineal trauma and spontaneous perineal tears","volume":"50","author":"Martin S","year":"2001","journal-title":"J Fam Pract"},{"key":"e_1_2_6_10_2","first-page":"752","article-title":"Risk factors for third\u2010degree perineal tears in vaginal delivery, with an analysis of episiotomy types","volume":"46","author":"Bodner\u2010Adler B","year":"2001","journal-title":"J Reprod Med"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(98)00207-0"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1526-9523(02)00415-4"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2005.05.012"},{"key":"e_1_2_6_14_2","volume-title":"SAS\/STAT User's Guide, Version","year":"1999"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0730-7659.2005.00365.x"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-200505000-00002"},{"key":"e_1_2_6_17_2","volume-title":"Listening To Mothers: Report of the First National U.S. Survey of Women's Childbearing Experiences","author":"Declercq ER","year":"2002"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000081"}],"container-title":["Birth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.0730-7659.2006.00085.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.0730-7659.2006.00085.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T13:20:25Z","timestamp":1697116825000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.0730-7659.2006.00085.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,5,24]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2006,6]]}},"alternative-id":["10.1111\/j.0730-7659.2006.00085.x"],"URL":"https:\/\/doi.org\/10.1111\/j.0730-7659.2006.00085.x","archive":["Portico"],"relation":{},"ISSN":["0730-7659","1523-536X"],"issn-type":[{"value":"0730-7659","type":"print"},{"value":"1523-536X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,5,24]]}}}