Midwifery Practices during the Second Stage of labour

• Research type

  Research Study

• Full title

  An exploration of the practices undertaken by midwives while supporting women during a normal, uncomplicated second stage of labour.

• IRAS ID

  139993

• Contact name

  Catherine J Hamilton

• Contact email

  c.j.hamilton@herts.ac.uk

• Sponsor organisation

  University of Hertfordshire

• Research summary

  In this study the practices which midwives undertake while supporting women during a normal, uncomplicated second stage of labour will be explored. It is intended to recruit ten to fifteen midwives with recent experience of supporting women during labour. The observational phase will be followed up with an interview in which the researcher will explore the decision making processes informing their practices.
  The second stage of labour is defined as the time from when the neck of the womb is fully open to the delivery of the baby. During this period the woman's expulsive efforts along, with uterine contractions assist the baby to move down the birth canal and be born. A key role of the midwife at this time is to support the woman to ensure a safe and positive experience of childbirth which will result in the birth of a healthy baby and minimal physical trauma to the woman. The latest evidence recommends that pushing during the second stage should not usually be directed but that women should be left undisturbed to push spontaneously as dictated by their own bodies. However, in certain cases directed pushing (known as the ‘Valsalva Manoeuvre’) may be acceptable if the woman requests further guidance or if there is a need to expediate the birth for example if the unborn baby is becoming physically compromised. Research also suggests that midwives can adopt either a ‘ hands on or hands poised’ approach to the second stage and that neither approach is superior to the other in terms of outcomes for the woman or her baby. This study aims to explore what midwives are doing to support women during the second stage and the processes underpinning their decisions in the light of the evidence base which in itself is not always clear cut.

• REC name

  London - Surrey Borders Research Ethics Committee

• REC reference

  13/LO/1597

• Date of REC Opinion

  22 Jan 2014

• REC opinion

  Further Information Favourable Opinion