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Does walking during labor help? Heidi Beimer, RN, talks about her role in a new study |
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Interview
by Michelle Lau Working with University of Texas Southwestern Medical Center staff, a team of nurses from Parkland Hospital in Dallas co-authored a recent study on labor and walking. The study, recently published in The New England Journal of Medicine, concluded that while walking during the course of labor may reduce a woman’s discomfort, it does not affect the duration of labor nor reduce the need for pain medication. Though the study’s lead investigator was a physician, the research concept was generated by a nurse. Heidi Beimer, RN, a Parkland labor and delivery nurse, was the primary nurse contact for patients in the study and was called "a key figure" in its success by the lead investigator. Beimer was responsible
for measuring the time each woman spent walking during her labor and
collected most of the study data. The research involved 1,067 women
with uncomplicated pregnancies who were between 36 and 41 weeks’ gestation.
Half the women were randomly assigned to bedrest and allowed to sit
up or lie down during labor, while half were encouraged to walk, but
return to bed if they needed pain relief or went into second-stage
labor. Three-hundred eighty of the women actually walked during active
labor. Q: What initiated the study? A: This research topic is something people have been talking about for a long time: Does ambulation have an effect on labor and its outcome? We all have our personal biases on this. So we got together and researched the literature and found out that there weren’t very many randomized studies that actually looked at ambulation and its effect on labor. Past findings concluded that ambulation affected labor and that patients would have less laboring time. A lot of institutions don’t believe this is true. They believe that you should actually be in bed, so patients aren’t given the opportunity to ambulate. We wanted to see if that was really something that made a difference. Q: Did the study have any impact on the way patients are currently treated at your hospital? A: Yes, it did. Actually, the findings of the study were that ambulation didn’t add to or take away from the labor experience. It didn’t speed up time, yet it wasn’t harmful in any way. Previously, our patients were pretty much on bedrest, and they were not permitted to walk. Now with these findings, people who want to get up and walk can do that. They can feel comfortable with it, knowing they’re not doing anything to hurt their baby. On the other hand, perhaps some patients don’t want to get up because they’re comfortable lying on their side on the bed. People can pretty much do what they have to in order to get through the pain. Q: How did the nurses in this study work in tandem with the physicians? Is such a collaborative effort rare? A: It was wonderful to be a part of something like this—to work on that level with physicians. We all have a fairly good working relationship. Our medical staff is very supportive of nursing services. They’re the type of people who want to help us expand our professional roles. They allowed us to have a lot of control on the study, and we actually did the work. In our department, there’s not a lot of nurse-generated research. There is in the hospital, but not in our particular unit. So, the medical staff really wanted this study to go well. In fact, they encouraged us to continue with a few more projects that are in the planning process now. |
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