EVIDENCE-BASED RECOMMENDATIONS FOR NURSING CARE DURING THE SECOND STAGE OF LABOR A BEST PRACTICE APPROACH By TONYA ROCHELLE KING

The purpose of this thesis was to develop best practice recommendations to care for women in the second stage of labor. Evidence suggests that care of women during the second stage of labor using upright positioning, delayed pushing, application of warm compresses to the perineum, and perineal massage can improve maternal and neonatal outcomes (Aasheim et al., 2011; Brancato et al., 2008; Chang et al., 2011; Dahlen et al., 2007; Dahlen et al., 2009; Gillesby et al., 2010; Gupta et al., 2012; Kelly et al., 2010; Sanders et al., 2005; Schaub et al., 2008; Simpson & James, 2005; Terry et al., 2006; Thies-Lagergren et al., 2013). A theoretical plan for implementation and evaluation of best practice recommendations for the second stage of labor was discussed in this paper. Registered nurses implementing evidence-based recommendations within the hospital setting for pregnant women regarding delayed pushing, upright labor positions, and interventions to reduce perineal trauma and pain, would provide women care that may improve second stage of labor outcomes. NURSING CARE DURING SECOND STAGE OF LABOR 3 CHAPTER