Sterile Water

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Sue Kildea - One of the best experts on this subject based on the ideXlab platform.

  • knowledge and use of Sterile Water injections amongst midwives in the united kingdom a cross sectional study
    2019
    Co-Authors: Nigel Lee, Lena Mårtensson, Sue Kildea, Julie Jomeen, Vanessa Emery
    Abstract:

    Background: The use of Sterile Water injections (SWI) for the relief of pain in labour is popular amongst midwives in countries such as Sweden and Australia. Anecdotal reports suggest the procedure ...

  • tough love the experiences of midwives giving women Sterile Water injections for the relief of back pain in labour
    2017
    Co-Authors: Nigel Lee, Sue Kildea, Helen Stapleton
    Abstract:

    Abstract Objective To explore midwives' experiences of administering Sterile Water injections (SWI) to labouring women as analgesia for back pain in labour. Design A qualitative study, which generated data through semi-structured focus group interviews with midwives. Data were analysed thematically. Setting Two metropolitan maternity units in Queensland, Australia. Participants Eleven midwives who had administered SWI for back pain in labour in a randomised controlled trial. Findings Three major themes were identified including: i. SWI, is it an intervention?; ii. Tough love, causing pain to relieve pain; iii. The analgesic effect of SWI and impact on midwifery practice. Key conclusions Whilst acknowledging the potential benefits of SWI as an analgesic the midwives in this study described a dilemma between inflicting pain to relieve pain and the challenges encountered in their discussions with women when offering SWI. Midwives also faced conflict when women requested SWI in the face of institutional resistance to its use. Implications for practice The procedural pain associated with SWI may discourage some midwives from offering women the procedure, providing women with accurate information regarding the intensity and the brevity of the injection pain and the expected degree of analgesic would assist in discussion about SWI with women.

  • no pain no gain the experience of women using Sterile Water injections
    2017
    Co-Authors: Nigel Lee, Sue Kildea, Helen Stapleton
    Abstract:

    Abstract Problem/background Sterile Water injections (SWI) are gaining popularity amongst women and midwives for the relief of back pain in labour. However the brief but intense pain associated with the injection has been cited as a deterrent to use and may negatively affect the birth experience. Aim To explore women’s experiences of using Sterile Water injections as analgesia for back pain in labour. Design A qualitative study, which generated data through individual semi-structured interviews with postnatal women. Data were analysed thematically. Setting Two metropolitan maternity units in Queensland, Australia. Participants Nine postnatal women who had participated in a randomised controlled trial investigating the use of Sterile Water injections for back pain in labour Findings Three major themes were identified including Sterile Water injections as a non-pharmacological injection; balancing injection pain against expectations of pain relief; the analgesic effect of Sterile Water injections. Key conclusions Women in this study largely viewed Sterile Water injections as an effective analgesia with few side effects. The pain associated with the injection of Sterile Water was weighed against the likelihood of rapid, effective pain relief. Women used the period of analgesia to support their objectives, be this a period of respite during the labour or to enhance the ability to focus on the birth experience. Information on SWI provided by health professionals should also balance realistic descriptions of the injection pain with prospect of analgesia.

  • comparison of a single vs a four intradermal Sterile Water injection for relief of lower back pain for women in labour a randomised controlled trial
    2013
    Co-Authors: Sue Kildea, Helen Stapleton, Joan Webster, Kristen Gibbons, Michael Beckmann, Tric Smith
    Abstract:

    Abstract Objective Sterile Water injections are a simple, safe, effective, non-pharmacological technique for relieving back pain in labour, however the number of injections required to achieve optimal analgesia is unknown. The objective of this trial was to evaluate the degree and duration of analgesia provided by a single injection of Sterile Water, compared to four injections. Design randomised controlled non-inferiority trial. Participants and setting three hundred and five women in labour at term, requesting analgesia for back pain were recruited from two metropolitan hospitals in Brisbane, Australia. Intervention participants were randomly assigned to receive either one ( n =147) or four ( n =158) Sterile Water injections. Outcome measures difference in self-reported pain measured using a visual analogue scale (VAS) between baseline and 30mins post-intervention. The clinically acceptable margin of difference was defined as ≤1cm on the VAS between the single injection compared to four injection technique. Secondary outcomes include VAS score on injection and 10, 60, 90 and 120mins post-intervention, analgesia use, mode of birth and maternal satisfaction. Findings the mean difference in the pre and post (30mins) injection scores between two groups was −1.48cm (95% CI −2.10, −0.86) in favour of the FI technique, however the injection pain associated with the FI was significantly greater than that of the SI technique ( p Conclusion the four injection technique was associated with increased level of analgesia at 30mins post-intervention compared to the single injection, but also a greater degree of injection pain.

  • cross sectional study of australian midwives knowledge and use of Sterile Water injections for pain relief in labour
    2012
    Co-Authors: Nigel Lee, Lena Mårtensson, Sue Kildea
    Abstract:

    Background: The effectiveness of Sterile Water injections (SWI) to relieve back pain in labour is supported by a number of randomised controlled trials. Although the procedure is available in a num ...

Nigel Lee - One of the best experts on this subject based on the ideXlab platform.

  • knowledge and use of Sterile Water injections amongst midwives in the united kingdom a cross sectional study
    2019
    Co-Authors: Nigel Lee, Lena Mårtensson, Sue Kildea, Julie Jomeen, Vanessa Emery
    Abstract:

    Background: The use of Sterile Water injections (SWI) for the relief of pain in labour is popular amongst midwives in countries such as Sweden and Australia. Anecdotal reports suggest the procedure ...

  • tough love the experiences of midwives giving women Sterile Water injections for the relief of back pain in labour
    2017
    Co-Authors: Nigel Lee, Sue Kildea, Helen Stapleton
    Abstract:

    Abstract Objective To explore midwives' experiences of administering Sterile Water injections (SWI) to labouring women as analgesia for back pain in labour. Design A qualitative study, which generated data through semi-structured focus group interviews with midwives. Data were analysed thematically. Setting Two metropolitan maternity units in Queensland, Australia. Participants Eleven midwives who had administered SWI for back pain in labour in a randomised controlled trial. Findings Three major themes were identified including: i. SWI, is it an intervention?; ii. Tough love, causing pain to relieve pain; iii. The analgesic effect of SWI and impact on midwifery practice. Key conclusions Whilst acknowledging the potential benefits of SWI as an analgesic the midwives in this study described a dilemma between inflicting pain to relieve pain and the challenges encountered in their discussions with women when offering SWI. Midwives also faced conflict when women requested SWI in the face of institutional resistance to its use. Implications for practice The procedural pain associated with SWI may discourage some midwives from offering women the procedure, providing women with accurate information regarding the intensity and the brevity of the injection pain and the expected degree of analgesic would assist in discussion about SWI with women.

  • no pain no gain the experience of women using Sterile Water injections
    2017
    Co-Authors: Nigel Lee, Sue Kildea, Helen Stapleton
    Abstract:

    Abstract Problem/background Sterile Water injections (SWI) are gaining popularity amongst women and midwives for the relief of back pain in labour. However the brief but intense pain associated with the injection has been cited as a deterrent to use and may negatively affect the birth experience. Aim To explore women’s experiences of using Sterile Water injections as analgesia for back pain in labour. Design A qualitative study, which generated data through individual semi-structured interviews with postnatal women. Data were analysed thematically. Setting Two metropolitan maternity units in Queensland, Australia. Participants Nine postnatal women who had participated in a randomised controlled trial investigating the use of Sterile Water injections for back pain in labour Findings Three major themes were identified including Sterile Water injections as a non-pharmacological injection; balancing injection pain against expectations of pain relief; the analgesic effect of Sterile Water injections. Key conclusions Women in this study largely viewed Sterile Water injections as an effective analgesia with few side effects. The pain associated with the injection of Sterile Water was weighed against the likelihood of rapid, effective pain relief. Women used the period of analgesia to support their objectives, be this a period of respite during the labour or to enhance the ability to focus on the birth experience. Information on SWI provided by health professionals should also balance realistic descriptions of the injection pain with prospect of analgesia.

  • impact on caesarean section rates following injections of Sterile Water icaris a multicentre randomised controlled trial
    2013
    Co-Authors: Lena Mårtensson, Nigel Lee, Helen Stapleton, Caroline S E Homer, Joan Webster, Kristen Gibbons, Natalie Dos Santos
    Abstract:

    Sterile Water injections have been used as an effective intervention for the management of back pain during labour. The objective of the current research is to determine if Sterile Water injections, as an intervention for back pain in labour, will reduce the intrapartum caesarean section rate. Design: A double blind randomised placebo controlled trial Setting: Maternity hospitals in Australia Participants: 1866 women in labour, ≥18 years of age who have a singleton pregnancy with a fetus in a cephalic presentation at term (between 37 + 0 and 41 + 6 weeks gestation), who assess their back pain as equal to or greater than seven on a visual analogue scale when requesting analgesia and able to provide informed consent. Intervention: Participants will be randomised to receive either 0.1 to 0.3 millilitres of Sterile Water or a normal saline placebo via four intradermal injections into four anatomical points surrounding the Michaelis’ rhomboid over the sacral area. Two injections will be administered over the posterior superior iliac spine (PSIS) and the remaining two at two centimetres posterior, and one centimetre medial to the PSIS respectively. Main outcome measure:Proportion of women who have a caesarean section in labour. Randomisation: Permuted blocks stratified by research site. Blinding (masking):Double-blind trial in which participants, clinicians and research staff blinded to group assignment. Funding:Funded by the National Health and Medical Research Council Trial registration:Australian New Zealand Clinical Trials Registry (No ACTRN12611000221954 ). Sterile Water injections, which may have a positive effect on reducing the CS rate, have been shown to be a safe and simple analgesic suitable for most maternity settings. A procedure that could reduce intervention rates without adversely affecting safety for mother and baby would benefit Australian families and taxpayers and would reduce requirements for maternal operating theatre time. Results will have external validity, as the technique may be easily applied to maternity populations outside Australia. In summary, the results of this trial will contribute High level evidence on the impact of SWI on intrapartum CS rates and provide evidence of the analgesic effect of SWI on back pain.

  • cross sectional study of australian midwives knowledge and use of Sterile Water injections for pain relief in labour
    2012
    Co-Authors: Nigel Lee, Lena Mårtensson, Sue Kildea
    Abstract:

    Background: The effectiveness of Sterile Water injections (SWI) to relieve back pain in labour is supported by a number of randomised controlled trials. Although the procedure is available in a num ...

Lena Mårtensson - One of the best experts on this subject based on the ideXlab platform.

  • knowledge and use of Sterile Water injections amongst midwives in the united kingdom a cross sectional study
    2019
    Co-Authors: Nigel Lee, Lena Mårtensson, Sue Kildea, Julie Jomeen, Vanessa Emery
    Abstract:

    Background: The use of Sterile Water injections (SWI) for the relief of pain in labour is popular amongst midwives in countries such as Sweden and Australia. Anecdotal reports suggest the procedure ...

  • impact on caesarean section rates following injections of Sterile Water icaris a multicentre randomised controlled trial
    2013
    Co-Authors: Lena Mårtensson, Nigel Lee, Helen Stapleton, Caroline S E Homer, Joan Webster, Kristen Gibbons, Natalie Dos Santos
    Abstract:

    Sterile Water injections have been used as an effective intervention for the management of back pain during labour. The objective of the current research is to determine if Sterile Water injections, as an intervention for back pain in labour, will reduce the intrapartum caesarean section rate. Design: A double blind randomised placebo controlled trial Setting: Maternity hospitals in Australia Participants: 1866 women in labour, ≥18 years of age who have a singleton pregnancy with a fetus in a cephalic presentation at term (between 37 + 0 and 41 + 6 weeks gestation), who assess their back pain as equal to or greater than seven on a visual analogue scale when requesting analgesia and able to provide informed consent. Intervention: Participants will be randomised to receive either 0.1 to 0.3 millilitres of Sterile Water or a normal saline placebo via four intradermal injections into four anatomical points surrounding the Michaelis’ rhomboid over the sacral area. Two injections will be administered over the posterior superior iliac spine (PSIS) and the remaining two at two centimetres posterior, and one centimetre medial to the PSIS respectively. Main outcome measure:Proportion of women who have a caesarean section in labour. Randomisation: Permuted blocks stratified by research site. Blinding (masking):Double-blind trial in which participants, clinicians and research staff blinded to group assignment. Funding:Funded by the National Health and Medical Research Council Trial registration:Australian New Zealand Clinical Trials Registry (No ACTRN12611000221954 ). Sterile Water injections, which may have a positive effect on reducing the CS rate, have been shown to be a safe and simple analgesic suitable for most maternity settings. A procedure that could reduce intervention rates without adversely affecting safety for mother and baby would benefit Australian families and taxpayers and would reduce requirements for maternal operating theatre time. Results will have external validity, as the technique may be easily applied to maternity populations outside Australia. In summary, the results of this trial will contribute High level evidence on the impact of SWI on intrapartum CS rates and provide evidence of the analgesic effect of SWI on back pain.

  • cross sectional study of australian midwives knowledge and use of Sterile Water injections for pain relief in labour
    2012
    Co-Authors: Nigel Lee, Lena Mårtensson, Sue Kildea
    Abstract:

    Background: The effectiveness of Sterile Water injections (SWI) to relieve back pain in labour is supported by a number of randomised controlled trials. Although the procedure is available in a num ...

  • Sterile Water injections as treatment for low back pain during labour a review
    2008
    Co-Authors: Lena Mårtensson, Gunnar Wallin
    Abstract:

    Background: Some women have severe low-back pain during childbirth. It has been shown that Sterile Water injections reduce this pain. This method, which is easy to learn and very cheap can be a goo ...

  • us midwives knowledge and use of Sterile Water injections for labor pain
    2008
    Co-Authors: Lena Mårtensson, Maureen Mcswiggin, Judith S Mercer
    Abstract:

    The purpose of this research study was to identify and describe US midwives' knowledge and use of Sterile Water injections to relieve pain during labor. Research studies have shown that injections of Sterile Water to relieve low back pain during labor are effective with good maternal satisfaction. However, no knowledge is available about their use by midwives in the United States. Questionnaires were mailed to a random sample (N = 450) of midwives who were members of the American College of Nurse-Midwives (ACNM). One hundred thirty-two respondents (29%) returned the questionnaire. One-fourth (26%) of the midwives use Sterile Water injections, although infrequently. More than half of the midwives use the intracutaneous injection technique, and most use a total of four injections. Most midwives give the injections between contractions, with the assistance of another person, and report very good pain relief. Of those not using Sterile Water injections, most had no experience or training in use of the method and were interested in learning more about their use. While Sterile Water injections are a good treatment for back pain during labor, there is a lack of knowledge among midwives about this method of pain relief during labor and an interest in knowing more.

Gunnar Wallin - One of the best experts on this subject based on the ideXlab platform.

Joan Webster - One of the best experts on this subject based on the ideXlab platform.

  • comparison of a single vs a four intradermal Sterile Water injection for relief of lower back pain for women in labour a randomised controlled trial
    2013
    Co-Authors: Sue Kildea, Helen Stapleton, Joan Webster, Kristen Gibbons, Michael Beckmann, Tric Smith
    Abstract:

    Abstract Objective Sterile Water injections are a simple, safe, effective, non-pharmacological technique for relieving back pain in labour, however the number of injections required to achieve optimal analgesia is unknown. The objective of this trial was to evaluate the degree and duration of analgesia provided by a single injection of Sterile Water, compared to four injections. Design randomised controlled non-inferiority trial. Participants and setting three hundred and five women in labour at term, requesting analgesia for back pain were recruited from two metropolitan hospitals in Brisbane, Australia. Intervention participants were randomly assigned to receive either one ( n =147) or four ( n =158) Sterile Water injections. Outcome measures difference in self-reported pain measured using a visual analogue scale (VAS) between baseline and 30mins post-intervention. The clinically acceptable margin of difference was defined as ≤1cm on the VAS between the single injection compared to four injection technique. Secondary outcomes include VAS score on injection and 10, 60, 90 and 120mins post-intervention, analgesia use, mode of birth and maternal satisfaction. Findings the mean difference in the pre and post (30mins) injection scores between two groups was −1.48cm (95% CI −2.10, −0.86) in favour of the FI technique, however the injection pain associated with the FI was significantly greater than that of the SI technique ( p Conclusion the four injection technique was associated with increased level of analgesia at 30mins post-intervention compared to the single injection, but also a greater degree of injection pain.

  • impact on caesarean section rates following injections of Sterile Water icaris a multicentre randomised controlled trial
    2013
    Co-Authors: Lena Mårtensson, Nigel Lee, Helen Stapleton, Caroline S E Homer, Joan Webster, Kristen Gibbons, Natalie Dos Santos
    Abstract:

    Sterile Water injections have been used as an effective intervention for the management of back pain during labour. The objective of the current research is to determine if Sterile Water injections, as an intervention for back pain in labour, will reduce the intrapartum caesarean section rate. Design: A double blind randomised placebo controlled trial Setting: Maternity hospitals in Australia Participants: 1866 women in labour, ≥18 years of age who have a singleton pregnancy with a fetus in a cephalic presentation at term (between 37 + 0 and 41 + 6 weeks gestation), who assess their back pain as equal to or greater than seven on a visual analogue scale when requesting analgesia and able to provide informed consent. Intervention: Participants will be randomised to receive either 0.1 to 0.3 millilitres of Sterile Water or a normal saline placebo via four intradermal injections into four anatomical points surrounding the Michaelis’ rhomboid over the sacral area. Two injections will be administered over the posterior superior iliac spine (PSIS) and the remaining two at two centimetres posterior, and one centimetre medial to the PSIS respectively. Main outcome measure:Proportion of women who have a caesarean section in labour. Randomisation: Permuted blocks stratified by research site. Blinding (masking):Double-blind trial in which participants, clinicians and research staff blinded to group assignment. Funding:Funded by the National Health and Medical Research Council Trial registration:Australian New Zealand Clinical Trials Registry (No ACTRN12611000221954 ). Sterile Water injections, which may have a positive effect on reducing the CS rate, have been shown to be a safe and simple analgesic suitable for most maternity settings. A procedure that could reduce intervention rates without adversely affecting safety for mother and baby would benefit Australian families and taxpayers and would reduce requirements for maternal operating theatre time. Results will have external validity, as the technique may be easily applied to maternity populations outside Australia. In summary, the results of this trial will contribute High level evidence on the impact of SWI on intrapartum CS rates and provide evidence of the analgesic effect of SWI on back pain.

  • a randomised non inferiority controlled trial of a single versus a four intradermal Sterile Water injection technique for relief of continuous lower back pain during labour
    2011
    Co-Authors: Peter Coxeter, Sue Kildea, Joan Webster, Michael Beckmann, Tric Smith, Vanessa Wright
    Abstract:

    Background Almost one third of women suffer continuous lower back pain during labour. Evidence from three systematic reviews demonstrates that Sterile Water injections (SWI) provide statistically and clinically significant pain relief in women experiencing continuous lower back pain during labour. The most effective technique to administer SWI is yet to be determined. Therefore, the aim of this study is to determine if the single injection SWI technique is no less effective than the routinely used four injection SWI method in reducing continuous lower back pain during labour.

  • a randomised non inferiority controlled trial of a single versus a four intradermal Sterile Water injection technique for relief of continuous lower back pain during labour
    2011
    Co-Authors: Nigel Lee, Sue Kildea, Joan Webster, Michael Beckmann, Tric Smith, Peter Coxeter, Vanessa Wright
    Abstract:

    Almost one third of women suffer continuous lower back pain during labour. Evidence from three systematic reviews demonstrates that Sterile Water injections (SWI) provide statistically and clinically significant pain relief in women experiencing continuous lower back pain during labour. The most effective technique to administer SWI is yet to be determined. Therefore, the aim of this study is to determine if the single injection SWI technique is no less effective than the routinely used four injection SWI method in reducing continuous lower back pain during labour. The trial protocol was developed in consultation with an interdisciplinary team of clinical researchers. We aim to recruit 319 women presenting at term, seeking analgesia for continuous severe lower back pain during labour. Participants will be recruited from two major maternity hospitals in Australia. Randomised participants are allocated to receive a four or single intradermal needle SWI technique. The primary outcome is the change in self-reported pain measured by visual analogue scale at baseline and thirty minutes post intervention. Secondary outcomes include VAS change scores at 10, 60, 90 and 120 min, analgesia use, mode of birth and maternal satisfaction. Sample size was calculated to achieve 90% power at an alpha of 0.025 to detect a non-inferiority margin of ≤ 1 cm on the VAS, using a one-sided, two-sample t-test. Baseline demographic and clinical characteristics will be analysed for comparability between groups. Differences in primary (VAS pain score) and secondary outcomes between groups will be analysed by intention to treat and per protocol analysis using Student's t-test and ANOVA. This study will determine if a single intradermal SWI technique is no less effective than the routinely used four injection technique for lower back pain during labour. The findings will allow midwives to offer women requesting SWI during labour an evidence-based alternative technique more easily administered by staff and accepted by labouring women. ACTRN12609000964213

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