Abstract
Background
One of the factors that leads to intervention during labour and birth is the way the progress of labour is assessed and the definition of normal or abnormal progress. The most common assessment used is vaginal examination (VE) to assess cervical dilation. This approach is so dominant, that ‘progress’ in labour commonly stands for ‘cervical dilation’. However, with growing concern about medicalisation of childbirth, rising caesarean rates and dwindling numbers of physiological births, it is imperative to explore contemporary practice of labour progress assessment and how this practice impacts on women’s likelihood to experience a physiological birth.
Objectives
The aim of this research was to determine how the progress of labour and birth is assessed by health professionals in Australia.
Methods
Using feminist narrative research methodology, twenty Australian midwives and doctors were interviewed. Data was analysed to identify themes occurring across the narratives.
Results
Participants described how they used a variety of methods to assess or predict the progress of labour. Participants stated they rarely used VEs, however, used ‘other ways of knowing’ to assess progress. There was a distinct difference in the way progress was assessed in the medical model and the holistic midwifery model. These ‘other ways of knowing’ were often considered unreliable or unscientific in the dominant medical model of care.
Conclusions
Vaginal examination is considered the most common way to assess progress, however, midwives use a range of skills to assess labour progress. These ‘other ways of knowing’ are rarely discussed or documented in the mainstream maternity setting and may have the potential to reduce unnecessary interventions during labour and birth.
