Physiological Compared to Active Management -Interviews with Midwives
Research type
Research Study
Full title
Risks and benefits of physiological management compared to active management of the third stage of labour for women at low risk of postpartum haemorrhage- Semi-structured interviews with midwives experienced in normal pregnancy and birth
IRAS ID
203549
Contact name
Karen Clare Baker
Contact email
Sponsor organisation
University of Huddersfield
Duration of Study in the UK
0 years, 6 months, 24 days
Research summary
What are midwives, experienced in normal pregnancy and birth, views and experiences regarding the adverse and beneficial outcomes of the third stage of labour, related to the method of the third stage of labour care management (physiological versus active), for women at low risk of postpartum haemorrhage giving birth in alternative birth setting?
The third stage of labour is described as potentially the most risky part of childbirth for the woman because of the risk of a postpartum haemorrhage (PPH). Care in the third stage of labour aims to reduce blood loss, consisting of two clinical approaches: physiological and active management.
Physiological management is only appropriate for women at low risk of PPH. Active management is recommended for all women by national and international guidelines, regarding care in the third stage of labour. This is because research studies show an increase in PPH with physiological management (Begley et al. 2015, Begley et al. 2011a; Prendiville, Elbourne, McDonald 2000). However, these studies were conducted in obstetric lead maternity units and included women who were not at low and high risk of PPH. Furthermore many of the women who were allocated to physiological management did not receive it.
More recently, two cohort research studies(Dixon et al. 2013 and Fahy et al. 2010), involving only women at low risk of PPH who gave birth in obstetric units and alternative birth settings found more women who had physiological management rather than active management had a blood loss of less than 500mLs. These findings are in stark contrast to the findings of three consecutive Cochrane systematic reviews (Prendiville et al. 2000, Begley et al. 2011, Begley et al 2015).
There is limited research involving midwives providing care for women defined as low risk of complications during the pregnancy and birth continuum, working in alternative birth setting. These midwives views and experiences are important as midwives working in these setting are experienced in supporting normality. Furthermore, previous research indicates they are more experienced in physiological management than midwives working on obstetric units. Consequently, their views and experiences regarding this area of maternity care for women at low risk of complications during the pregnancy and birth continuum will be valuable. The information gained from this research will then contribute to the existing body of knowledge with the aim to improve care management during the third stage of labour.
Eligibility for study: Semi-structured interviews with up to 20 midwife who: work at the NHS Foundation Trust; provide care for women at low risk of PPH, who give birth at the birth centres or at home. The study will be conducted 1/6/16, end date 31/7/16
REC name
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REC reference
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