Evaluation of Labor Mirror Use During the Active Pushing Phase of the Second Stage of Labor.

Abstract

Objective: To evaluate whether the use of a labor mirror during the active pushing phase of the second stage of labor is associated with a shorter duration of pushing. Additionally, we examined maternal and neonatal outcomes secondary to mirror use versus non-mirror use.

Design: Retrospective observational cohort study.

Setting/local problem: Community hospital in the midwestern United States with a Level 3 maternity center and approximately 2,000 births annually.

Participants: Four hundred fifty-three women ≥18 years old who had a singleton pregnancy at term (37-41 weeks' gestation) with a spontaneous vaginal birth.

Intervention/measurements: The use of a ceiling-mounted labor mirror offered before or at the beginning of the active pushing phase of the second stage of labor. Use was determined by patient choice.

Results: One hundred seventy-seven (39.1%) women elected use of the labor mirror. Mirror users and nonusers were similar in terms of clinical and demographic characteristics except for epidural use (93.2% vs. 86.6%, respectively; p = .0298). Among nulliparous women who used the mirror, second stage labor duration was shortened by an average of 19.4 minutes (p = .0198). This effect was not seen in multiparous women (p = .2208). Mirror users and nonusers did not differ on rates of postpartum hemorrhage (p = .5498) or chorioamnionitis (p = .6528). Among nulliparous and multiparous women, Apgar scores and NICU admission rates did not differ between mirror users and nonusers.

Conclusion: The labor mirror represents a simple, noninvasive tool for labor and delivery units. Use of the labor mirror during the active pushing phase of the second stage of labor may be associated with decreased pushing duration for nulliparous women.