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Irish and New Zealand midwives’ expertise in expectant management of the third stage of labour: the ’MEET’ study - Midwifery - Vol. 28, 6 - ISBN: 1532-3099 - p.733-739

Auteur·e(s) :

Begley, Cecily M.; Guilliland, Karen; Dixon, Lesley; Reilly, Mary; Keegan, Caroline

Année de publication :

2012

URL(s) :

https://doi.org/10.1016/j.midw.2011.08.008

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: to explore the views of expert midwives in Ireland and New Zealand of the skills they employ in expectant management of the third stage of labour (EMTSL).

DESIGN: university ethical approval was granted for a qualitative descriptive study in 2010. Recorded, semi-structured interviews were undertaken. Constant comparative analysis was used.

SETTING: community birth settings in Ireland and New Zealand.

PARTICIPANTS: 27 consenting midwives who used EMTSL in at least 30% of births, with PPH rates less than 4%.

FINDINGS: the majority of respondents believed the third stage was a special time of parent-baby discovery and ’watchful waiting’, with no intervention necessary. Great importance was placed on women’s feelings, behaviour and a calm environment. Skin-to-skin contact, breast feeding, not clamping the cord, upright positions and maternal effort, sometimes assisted by gentle cord-traction were also used.

KEY CONCLUSIONS: some components of EMTSL identified by these expert midwives are not recorded in text-books, but are based on experience and expertise. These elements of EMTSL add to midwifery knowledge and provide a basis for further discussion on how normal physiology can be supported during the third stage.

IMPLICATIONS FOR PRACTICE: use of these elements is recommended for women who request EMTSL, and for those in countries without ready access to uterotonics.

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Import 12/05/2016 — 12 May 2016