Independent midwives' care for “prolonged labor”

Abstract

Purpose

To investigate how independent midwives assess “prolonged labor”, and identify the actual state of midwifery care to promote the progress of labor.

Subjects and Methods

This study involved 3 independent midwives who have >15 years of working experience as a midwife and >3 years of experience as an independent midwife. Data were collected through semi-structured interviews, and the interviews were recorded using an IC recorder with the consent of the subjects. During the interview, the subjects freely talked about how they assess “prolonged labor” during the stages of pregnancy and labor, and the type of midwifery care they provide based on the prediction and assessment they made. The interview data were transcribed verbatim and analyzed using approach of the KJ method.

Results

Midwifery care provided by independent midwives for “prolonged labor” was described as follows: Independent midwives in this study valued [positive attitudes toward labor] and had [a philosophy to care for every pregnant and parturient woman in this world] in the practice of midwifery care. During the pregnancy stage, they provided [advice for successful progress of labor from the pregnancy stage]. During the labor stage, the midwives assessed the labor progress based on [assessment criteria developed based on their basic knowledge and experience]. Based on their assessment, they provided [care according to women's health status during the labor stage], in order for labor to progress smoothly.

Conclusions

In the care of pregnant and parturient women, the independent midwives placed value on developing a mutual trusting relationship with women, sharing the same belief that mothers and babies have potentials and possibilities, and helping the women accept their labor. They also maintained a holistic view to predict the probability of “prolonged labor”, and to prepare for women to have a smooth delivery. During the labor stage, the midwives assessed and practiced the care necessary for “prolonged labor” based on the information they obtained in the relationship from the pregnancy stage and according to the women's situation. In the future, midwifery care provided by such independent midwives must be shared among and passed on to midwives who are involved in the care of pregnant and parturient women.