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Swedish midwives' rating of risks during labour progress and their attitudes toward performing intrapartum interventions: A web-based survey
Division of Obstetrics and Gynecology, Karolinska Institutet, Danderyd Hospital.ORCID iD: 0000-0002-7840-7885
2012 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, no 4, p. e516-e520Article in journal (Refereed) Published
Abstract [en]

Objective: to study how Swedish midwives working in low-risk labour ward units rate intrapartum risks compared to their midwifery colleagues working in standard care labour wards. A second aim was to describe midwives' attitudes toward performing different types of interventions during a normal labour. Design: an explorative study was carried out in 2009, using a web-based questionnaire containing 31 questions on midwives' risk ratings and attitudes to interventions during labour, as well as personal comments. Setting: four labour ward units in Stockholm, Sweden. Two labour ward units with expected normal deliveries ('low-risk') and two standard care units with all types of deliveries. Participants: seventy-seven registered clinically practicing midwives. Findings: midwives in all units stated that factors to be considered for risk estimation were: previous delivery outcome, result of cardiotocography test (CTG) on admission to labour ward and quality of amniotic fluid. Midwives working at the low-risk units preferred to be more expectant during normal birth than their colleagues working at the standard care units. Examples of this were regarding second vaginal examination during labour (p=0.001) and/or amniotomy (p=0.012). Furthermore, midwives working at the low-risk units more often considered that first-time mothers could give birth without epidural analgesia during labour (p=0.019) and that the labouring woman should be encouraged to push according to her own spontaneous urge (p=0.040). Midwives at low-risk units were more reluctant to use an intravenous vein catheter than their colleagues at standard care units (p=0.001) and also to use oxytocin in order to augment contractions (p=0.013). Further, the open-ended question showed that attitudes to different types of interventions differed between midwives working at low-risk units or the standard care units working with all types of deliveries. Conclusion: the Swedish midwives estimated risks similarly regardless of whether they worked in low-risk or in standard care units, but midwives working at low-risk units reported that they perform less routine interventions and have a more expectant attitude towards performing interventions. © 2011 Elsevier Ltd.

Place, publisher, year, edition, pages
Churchill Livingstone , 2012. Vol. 28, no 4, p. e516-e520
Keywords [en]
Intrapartum care, Midwives, Normal birth, Risk perception
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:du-38891DOI: 10.1016/j.midw.2011.06.008Scopus ID: 2-s2.0-84864129129OAI: oai:DiVA.org:du-38891DiVA, id: diva2:1615602
Available from: 2021-11-30 Created: 2021-11-30 Last updated: 2021-11-30Bibliographically approved

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Wiklund, Ingela

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