Musculoskeletal lower back load of accoucheurs during childb
Back problems represent one of the leading causes of accoucheurs 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.

The aim of this study was to test the feasibility of determining the effect of different accoucheurs' 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 were observed. For the standing position, the spine load was reduced by pivoting the elbow on the accoucheur's thigh, which in turn was associated with a significantly greater load on the shoulder joint.

The study demonstrated the feasibility of the 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 kneeling, can significantly reduce the strain on the practitioner’s musculoskeletal system.

Source: https://doi.org/10.1016/j.ejogrb.2021.07.042
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