{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T23:39:50Z","timestamp":1781307590482,"version":"3.54.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the impact of free-position delivery combined with perineal massage on nursing-sensitive quality indicators and clinical outcomes in high-risk pregnant women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study analyzed clinical data from 223 high-risk pregnant women who underwent vaginal delivery between January 2023 and December 2024. Participants were allocated to either the Traditional Supine Delivery group (TSD,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009117) or the Free-Position and Perineal Massage group (FPPM,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009106) based on delivery mode. Baseline characteristics, durations of labor, perineal injuries, postpartum hemorrhage, anesthesia requirements, postpartum complications, neonatal conditions, psychological status, and maternal satisfaction were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with TSD, the FPPM group had shorter active first stage and second stage of labor (5.98\u2009\u00b1\u20091.25 vs. 6.33\u2009\u00b1\u20091.21\u2009h; 82.01\u2009\u00b1\u20098.14 vs. 85.48\u2009\u00b1\u20097.85\u2009min; both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), and a lower rate of perineal lacerations (59.43% vs. 76.07%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), episiotomy (16.04% vs. 27.35%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042), and postpartum hemorrhage \u2265500\u2009mL (5.66% vs. 13.68%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). FPPM also reduced intrapartum anesthesia requirements and postpartum complications while improved 5-min Apgar scores (9.80\u2009\u00b1\u20090.35 vs. 9.69\u2009\u00b1\u20090.42;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036), maternal satisfaction (69.81% vs. 52.14% very satisfied;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026), and PTSD symptoms (28.44\u2009\u00b1\u20092.31 vs. 29.52\u2009\u00b1\u20092.86;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Free-position delivery combined with perineal massage in high-risk pregnant women is associated with better nursing-sensitive quality indicators, lower rates of perineal trauma and postpartum complications, improved neonatal outcomes, and higher maternal satisfaction compared with traditional supine delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1661126","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T06:46:01Z","timestamp":1765953961000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of free-position delivery combined with perineal massage on reducing sensitive indicators of care quality in high-risk pregnant women"],"prefix":"10.3389","volume":"12","author":[{"given":"Ying","family":"Shen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"101362","DOI":"10.1016\/j.ajogmf.2024.101362","article-title":"Evidence-based cesarean delivery: preoperative management (part 7)","volume":"6","author":"Mackeen","year":"2024","journal-title":"Am J Obstet Gynecol MFM"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1002\/nop2.1382","article-title":"An evidence-based general anaesthesia and prone position nursing checklist: development and testing","volume":"10","author":"Cai","year":"2023","journal-title":"Nurs Open"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e37943","DOI":"10.7759\/cureus.37943","article-title":"Alternative birthing positions compared to the conventional position in the second stage of labor: a review","volume":"15","author":"Satone","year":"2023","journal-title":"Cureus"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.2147\/IJWH.S405077","article-title":"Inviting Newton to visit the delivery room. 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