The Length of the Active Phase of the Second Stage of Labour in Women
Giving Birth in Greenland Compared to Denmark: a pilot study
Abstract
Objective: Midwives in Greenland observe that people give birth faster,
with fewer complications tentatively due to early maternal expulsive
efforts in second stage. Our aim was to quantify these observations and
potential geographical differences. Design: Bicentre observational
prospective cohort study. Method: Between October and December 2020, 50
participants in labour in Aabenraa (Denmark) and Nuuk (Greenland)
participated. Transperineal head-perineum distance was measured with a
handheld ultrasound scanner. Negative binomial regression was used to
calculate incidence rate ratio. Fetomaternal outcome was recorded and
compared Results: The median duration of maternal expulsive efforts was
23 minutes in Denmark compared to 10 minutes in Greenland (p=0.046).
This was adjusted for parity, epidural use and gestational age. In
Denmark 22 % and in Greenland 81 % started maternal expulsive efforts
before the fetal head was at the pelvic floor (p-value<
0.001). Conclusion: Although the duration of maternal expulsive efforts
and head-perineum distance was significantly different in the univariate
analysis, in the multivariate analysis this was not affected by
ethnicity. There was no significant difference in bleeding, perineal
tears, or Apgar scores. There is a tendency of a shorter duration of
maternal expulsive efforts in the active phase of the second stage of
labour distance in Greenland compared to practice in Denmark. However,
it seems that epidural and parity could be the main confounders to
explain the difference between the two groups, but this needs further
investigation.