Musculoskeletal lower back load of accoucheurs during childbirth – A pilot and feasibility study

• Published in: European journal of obstetrics & gynecology and reproductive biology 2021-09, Vol.264, p.306-313
• Main Authors: Melzner, Maximilian, Ismail, Khaled M., Rušavý, Zdeněk, Kališ, Vladimír, Süß, Franz, Dendorfer, Sebastian
• Format: Article
• Language: English
• Subjects: Accoucheur; Lower back load; Musculoskeletal simulation
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2021.07.042

Back problems represent one of the leading causes of accouchers’ work-related musculoskeletal morbidities. The correct execution of birth-related maneuvers including manual perineal protection is crucial not only for the mother and child but also for obstetricians and midwives to reduce any strain on their musculoskeletal system. Therefore, the overall aim of this study was to test the feasibility of determining the effect of different accouchers’ postures (standing and kneeling) on their musculoskeletal system. The biomechanical analysis is based on musculoskeletal simulations that included motion recordings of real deliveries as well as deliveries conducted on a birthing simulator. These simulations were then used to determine individual joints’ loads. In the kneeling posture, both a low intra-operator variability and a lower average maximum load of the lower back was observed. For the standing position the spine load was reduced by pivoting the elbow on the accouchers’ thigh, which in turn was associated with a significantly greater load on the shoulder joint. The study demonstrated the feasibility of our technique to assess joints loads. It also provided initial data indicating that a posture that reduces spinal flexion and tilt, achieved in this study by the kneeling, can significantly reduce the strain on the practitioner’s musculoskeletal system.