Swedish hospitals use alternative birth techniques selectively, but outcomes unclear
Two major Swedish hospitals documented Spinning Babies® techniques in 6% of deliveries, primarily for complicated labors. Researchers found higher surgical delivery rates in treated cases, but say the pattern likely reflects selective use in high-risk situations rather than evidence of harm or benefit—highlighting a gap in maternity care evidence.
Originaltitel: Spinning babies® techniques in two Swedish tertiary birth units: A retrospective cohort study of use and birth outcomes.
Spinning Babies®-tekniker användes i 6,4 procent av 2 182 förlossningar vid två svenska universitetssjukhus mellan oktober 2022 och februari 2023. Metoderna tillämpades främst vid inducerad, försvårad eller accelererad arbete. Studien från Ystad och Malmö visar att kejsarsnitt på grund av nödsituation förekom tredubbelt oftare (17,3 procent mot 5,8 procent) i gruppen som fick teknikerna, liksom instrumentell vaginal förlossning (18,0 procent mot 6,3 procent). Forskare från Göteborgs och Lunds universitet konstaterar att högre operativ förlossningsfrekvens sannolikt speglar bakomliggande komplexitet snarare än tekniken själv. Implementeringen var selektiv och endast partiell. För inköpschefer och chefsläkare är slutsatsen relevant: prospektiva studier i väl definierade patientgrupper behövs innan evidensbaserade riktlinjer kan fastställas för rutinomfattning av Spinning Babies®.
OBJECTIVE: To describe the clinical contexts of Spinning Babies® use and maternal, labour, and neonatal outcomes among women receiving these techniques as part of routine intrapartum care. METHODS: A retrospective descriptive cohort study at two Swedish tertiary hospitals (October 2022-February 2023) including 2182 term singleton births, of which 139 involved documented use of Spinning Babies®. Data were extracted from electronic medical records and analysed descriptively. RESULTS: Spinning Babies® techniques were recorded in 6.4% of births and were primarily used in induced, prolonged, or augmented labours. Higher proportions of operative births were observed in the Spinning Babies® group (emergency caesarean 17.3% vs 5.8%; instrumental vaginal birth 18.0% vs 6.3%). Documentation suggested selective use and partial implementation of core techniques. CONCLUSION: In this setting, Spinning Babies® techniques were mainly applied in clinically complex labours. Observed differences in outcomes likely reflect case mix and confounding by indication rather than causal effects. The findings should therefore be interpreted descriptively. Prospective studies in more clearly defined clinical populations are needed to evaluate implementation, indications for use, and effectiveness.