{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:56:12Z","timestamp":1783529772970,"version":"3.55.0"},"reference-count":45,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:00:00Z","timestamp":1721952000000},"content-version":"unspecified","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ALF","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Region South Funds","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Lions Club International Foundation","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"The Academy of Health Care Sciences at Skane university hospital","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"The Swedish Research Council for Health, Working life and Welfare","award":["2018-01192"],"award-info":[{"award-number":["2018-01192"]}]},{"name":"Regional research grants from the south region, Sweden","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,6,28]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"\n Objective<\/jats:title>\n To compare experiences of the second stage of labour in women randomised to assistance by one or by two midwives to reduce severe perineal trauma (SPT).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Analysis of a secondary outcome within the Swedish Oneplus multicentre randomised trial.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Five obstetric units in Sweden between December 2018 and March 2020.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Inclusion criteria in the Oneplus trial were women opting for their first vaginal birth from gestational week 37+0 with a singleton pregnancy and a live fetus in the vertex presentation. Further inclusion criteria were language proficiency in Swedish, English, Arabic or Farsi. Exclusion criteria were multiple pregnancies, intrauterine fetal demise and planned caesarean section. Of the 3059\u2009women who had a spontaneous vaginal birth, 2831\u2009women had consented to participate in the follow-up questionnaire.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Women were randomly assigned (1:1) to assistance by two midwives (intervention group) or one midwife (standard care) when reaching the second stage of labour.<\/jats:p>\n <\/jats:sec>\n \n Outcome measures<\/jats:title>\n Data were analysed by intention to treat. Comparisons between intervention and standard care regarding experiences of the second stage of labour were evaluated with items rated on Likert scales. The Student\u2019s t-test was used to calculate mean differences with 95% CIs.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In total 2221 (78.5%) women responded to the questionnaire. There were no statistically significant differences regarding women\u2019s experiences of being in control, feelings of vulnerability or pain. Women randomised to be assisted by two midwives agreed to a lesser extent that they could handle the situation during the second stage (mean 3.18 vs 3.26, 95%\u2009CI 0.01 to 0.15). Conducted subgroup analyses revealed that this result originated from one of the study sites.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The intervention\u2019s lack of impact on the experience of the second stage is of importance considering the reduction in SPT when being assisted by two midwives.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT03770962<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-077458","type":"journal-article","created":{"date-parts":[[2024,7,27]],"date-time":"2024-07-27T06:50:20Z","timestamp":1722063020000},"page":"e077458","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of collegial midwifery assistance during second stage of labour on women\u2019s experience: a follow-up from the Swedish Oneplus randomised controlled trial"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct03770962","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6013-5359","authenticated-orcid":false,"given":"Cecilia","family":"H\u00e4ggsg\u00e5rd","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Skane University Hospital, Lund, Sweden"},{"name":"Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Edqvist","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Women\u2019s Health and Health Professions, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Teleman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Skane University Hospital, Lund, Sweden"},{"name":"Department of Clinical Sciences, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Tern","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden"},{"name":"Department of Obstetrics and Gynecology, Skane University Hospital, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Rubertsson","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden"},{"name":"Department of Obstetrics and Gynecology, Skane University Hospital, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,27]]},"reference":[{"key":"2025121509363316000_14.7.e077458.1","doi-asserted-by":"crossref","first-page":"e464","DOI":"10.1016\/j.wombi.2021.11.005","article-title":"Women\u2019s experiences of the second stage of labour","volume":"35","author":"H\u00e4ggsg\u00e5rd","year":"2022","journal-title":"Women Birth"},{"key":"2025121509363316000_14.7.e077458.2","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1111\/jmwh.12199","article-title":"A review of evidence-based practices for management of the second stage of labor","volume":"59","author":"Kopas","year":"2014","journal-title":"J Midwifery Womens Health"},{"key":"2025121509363316000_14.7.e077458.3","doi-asserted-by":"crossref","unstructured":"Anderson T . 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