Professional experience and ergonomic aspects of midwives' work.
OBJECTIVE
The most frequent manner of attending childbirth imposes on midwives assuming poor body position affecting the musculoskeletal system. Long professional experience does not mitigate the negative effects. The adopted movement habit, as well as the type, number and frequency of actions influence the body posture. The aim of the study was to identify ergonomic threats of basic occupational midwives activities and how particular spinal segments arrangements while attending childbirth using the same technique in senior midwives differ from those of junior ones. It was also checked whether pain influences the working position assumed by midwives.


METHODS
Examinations were conducted in 95 midwives aged 21-50 (X = 29.25 ± 9.34): 51 graduates of BSc midwifery who worked 680 h in delivery rooms during obligatory practical classes and apprenticeship and 44 senior midwives with professional experience of 7-27 years (X = 14.84 ± 5.98). The study was threefold. The spinal alignment while performing work activities associated with attending childbirth was assessed using the OWAS system and the SonoSens Monitor, the center of gravity projection on basal plane--using the AccuGait AMTI stabilometric platform. The measurements were taken during a simulation of attending childbirth (on examination model). A survey was conducted aimed at identifying spinal pain.


RESULTS
Midwives' working postures require unnatural body alignments. Postural instability in the working position and no maximal usage of basal plane were observed. The work overload may afflict the musculoskeletal system, which was confirmed by different pain discomforts in 67.3% of the examinees.


CONCLUSIONS
Spinal alignment while attending childbirth is individually differentiated and in every case non-ergonomic. Identifying explicitly spinal overloads is difficult, but the most prevalent ones affect lumbar and cervical regions altogether. Spinal pain is frequently noted, both in junior and senior midwives, and is characteristic for midwives working in maximal movement ranges.
Department of Physiotherapy, Institute of Backgrounds of Physiotherapy, Higher School of Administration, Bielsko-Biała, Poland. olga.nc@interia.pl
Olga
O
Nowotny-Czupryna
Beata
B
Naworska
Anna
A
Brzęk
Janusz
J
Nowotny
Anna
A
Famuła
Bartosz
B
Kmita
Krzysztof
K
Bąk
D000328:Adult; D001416:Back Pain / Q000209:etiology / Q000503:physiopathology; D003696:Delivery Rooms; D006804:Ergonomics; D005260:Female; D006801:Humans; D008875:Middle Aged; D008880:Midwifery; D016273:Occupational Exposure; D060051:Occupational Injuries / Q000209:etiology / Q000503:physiopathology; D004856:Postural Balance / Q000502:physiology; D011187:Posture / Q000502:physiology; D011247:Pregnancy; D055815:Young Adult