MEASURING PROGRESS IN LABOUR WITHOUT THE USE OF VAGINAL EXAMINATION
Research type
Research Study
Full title
MEASURING PROGRESS IN LABOUR WITHOUT THE USE OF VAGINAL EXAMINATION Can midwives verbalisation of events in labour reveal tacit cues to reliably indicate progress in order to inform the design of a labour observation tool?
IRAS ID
161424
Contact name
Elizabeth Whitney
Contact email
Sponsor organisation
University of Bradford
Duration of Study in the UK
1 years, 7 months, 30 days
Research summary
Midwives care for women in normal labour. Since the 1950's labour progress has been assessed using vaginal examination(VE) to measure the cervix opening, which is then plotted against time on a Partogram (labour chart).
Concerns have been raised about the invasive nature of VE, the risk of infection and the accuracy and reliability of resulting measurements.Two recent Cochrane Reviews found insufficient evidence to support the use of both VE and Partogram; prompting recommendation for further urgent investigation, to inform the development of observational labour assessment tools, which can be tested across a wide range of women.
Two studies have demonstrated that midwives recognise other signs which indicate labour progress, and that these signs can be incorporated into a labour assessment tool. However, both relied on pre-existing evidence from dated textbooks, where the birth context was far removed from current practice. The resulting labour assessment tools have not been widely tested.
This study aims to find out what is known about labour progress by exploring the direct experience of midwives. Care of the woman will continue through the usual process. 'Thinking aloud', Midwives will tell their experience of events as they unfold in the labour room and this will be recorded using a lapel microphone. The recordings will be analysed and compared against the standard Partogram measures, to identify signs which may indicate labour progress. The resulting data will add to existing evidence observing labour progress and will inform the design of a labour observation tool (LOT), which can be tested in different practice settings.
Women will be invited to contribute to the data via a postnatal smartphone questionnaire to provide; a comparison of the woman's experience of labour progress with that of the midwife, and to assess the woman's experience of the midwife thinking aloud.REC name
Yorkshire & The Humber - Leeds East Research Ethics Committee
REC reference
15/YH/0491
Date of REC Opinion
22 Dec 2015
REC opinion
Further Information Favourable Opinion