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Journal article
Failure to progress or just normal? A constructivist grounded theory of physiological plateaus during childbirth
Women and birth : journal of the Australian College of Midwives, Vol.37(1), pp.229-239
2023
Abstract
Background and problem
During childbirth, one of the most common diagnoses of pathology is ‘failure to progress’, frequently resulting in labour augmentation and intervention cascades. However, failure to progress is poorly defined and evidence suggests that some instances of slowing, stalling and pausing labour patterns may represent physiological plateaus.
Aim
To explore how midwives conceptualise physiological plateaus and the significance such plateaus may have for women’s labour trajectory and birth outcome.
Methods
Twenty midwives across Australia participated in semi-structured interviews between September 2020 and February 2022. Constructivist grounded theory methodology was applied to analyse data, including multi-phasic coding and application of constant comparative methods, resulting in a novel theory of physiological plateaus that is firmly supported by participant data.
Findings
This study found that the conceptualisation of plateauing labour depends largely on health professionals’ philosophical assumptions around childbirth. While the Medical Dominant Paradigm frames plateaus as invariably pathological, the Holistic Midwifery Paradigm acknowledges plateaus as a common and valuable element of labour that serves a self-regulatory purpose and results in good birth outcomes for mother and baby.
Discussion
Contemporary medicalised approaches in maternity care, which are based on an expectation of continuous labour progress, appear to carry a risk for a misinterpretation of physiological plateaus as pathological.
Conclusion
This study challenges the widespread bio-medical conceptualisation of plateauing labour as failure to progress, encourages a renegotiation of what can be considered healthy and normal during childbirth, and provides a stimulus to acknowledge the significance of childbirth philosophy for maternity care practice.
Details
- Title
- Failure to progress or just normal? A constructivist grounded theory of physiological plateaus during childbirth
- Authors/Creators
- Marina Weckend - Edith Cowan UniversityKylie McCullough - Edith Cowan UniversityChristine Duffield - Edith Cowan UniversitySara Bayes - Edith Cowan UniversityClare Davison - Murdoch University, Ngangk Yira Institute for Change
- Publication Details
- Women and birth : journal of the Australian College of Midwives, Vol.37(1), pp.229-239
- Publisher
- Elsevier Ltd on behalf of Australian College of Midwives.
- Identifiers
- 991005609659407891
- Copyright
- © 2023 The Authors.
- Murdoch Affiliation
- Ngangk Yira Institute for Change
- Language
- English
- Resource Type
- Journal article
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