Early pushing urge in labour and midwifery practice: A prospective observational study at an Italian maternity hospital

Borrelli, Sara E.; Locatelli, Anna; Nespoli, Antonella

doi:10.1016/j.midw.2012.09.010

Cited by 7 publications

(14 citation statements)

References 13 publications

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“…Moreover, the midwives referred to the presence of physiological signs when helping women cope with EPU. This supports the idea of recent researchers about the physiology of EPU in the presence of good maternal and fetal conditions (Enkin et al, 2000;Downe, 2008;Borrelli et al, 2013). In light of this, the question that arises is whether midwives should let the woman do what she feels and go along with the pushes.…”

Section: Resultssupporting

confidence: 76%

“…According to both the existing literature (Enkin et al, 2000;Downe, 2003;Borrelli et al, 2013) and our findings, midwives might suggest techniques to alleviate the urge to push and to help the woman cope with it, such as change of maternal position, breathing techniques, vocalisation, lumbar back massage and use of bath. Epidural analgesia could be proposed by midwives when the woman is strongly struggling to cope with EPU after alternative non-pharmacological techniques are suggested.…”

Section: Resultsmentioning

confidence: 50%

“…In this paper, we included only data about midwives' approaches to EPU as other 7 quantitative data have been discussed in a previously published article (Borrelli et al, 2013). All the interviews were digitally recorded, listened/re-listened to, fully transcribed and analysed using an interpretive phenomenological approach (Smith et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…Although different incidence rates are reported in the literature (from 7.6% to 54%), a significant minority of childbearing women seem to be experiencing the EPU phenomenon during labour (Roberts et al, 1987;Downe, 2008;Borrelli et al, 2013). Midwives are consequently often called to help labouring women cope with this event (Petersen and Besuner, 1997).…”

Section: Introductionmentioning

confidence: 99%

“…The EPU has been traditionally considered as a pathological event, with a number of authors highlighting the increased risk of cervical damage and maternal exhaustion (Berkeley and Fairbairn, 1931;Benyon, 1957;Gaskin, 1990). More recently, researchers have reconsidered EPU as a physiological phenomenon when good maternal and fetal conditions are present (Enkin et al, 2000;Downe, 2008;Borrelli et al, 2013). However, the real incidence of EPU, the nature of the phenomenon and the optimum approach to management remain controversial areas.…”

Section: Introductionmentioning

confidence: 99%

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Midwives' approaches to early pushing urge in labour

Borrelli

Dattolo

Nespoli

2015

British Journal of Midwifery

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The objectives of this mixed-methods study were: a) to investigate midwives' approaches to early pushing urge; b) to explore midwives' perspectives and experiences of helping women cope with EPU. A quantitative observational methodology was adopted to investigate midwives' approaches to early pushing urge in 60 EPU cases. A qualitative phenomenological approach was carried out in order to gain more in-depth understanding of midwives' views and experiences of EPU  Independently from the undertaken approach, it is recommended that midwives need to work with each individual woman in the context of each labour to determine the best approach in the specific case. Midwives should acknowledge that women often strongly struggle to cope with EPU; provide women with explanations and information on EPU; empower mothers; offer individualised woman-centred care and emotional support. Factors that may facilitate midwives in helping women cope with EPU are: models of care considering one-to-one care and continuity of carer; supportive working environments promoting normality of labour and birth; observing a number of women experiencing EPU in labour; good team working and peer support.3

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Section: Resultssupporting

confidence: 76%

Section: Resultsmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Midwives' approaches to early pushing urge in labour

Borrelli

Dattolo

Nespoli

2015

British Journal of Midwifery

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Birth

Garrido¹,

Davidson²

2019

Music, Nostalgia and Memory

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Just go with your body? A conversation analytic study of the transition from first to second stage of labor in UK midwife‐led care

Jackson,

Beynon‐Jones

2024

Birth

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BackgroundThe transition from first to second stage of labor is poorly understood. While the onset of second stage is defined by cervical measurement, dilation cannot be directly sensed or externally observed. Thus, uncertainty exists when women report pushing urges before dilation is confirmed. This study aimed to explore how sensations of pushing and uncertainty over progress are interactionally managed.MethodsWe audio/video recorded the labors of 37 women in two midwife‐led units in England. Our analysis focused on a subset of 28 recordings that featured discussion of transition from first to second stage of labor. The interactions between midwives, laboring women and their birth partners were transcribed and analyzed using conversation analysis.ResultsWe identified a ‘pushing until proven otherwise’ rule granting temporary, contingent authority to bodily urges to push while tracking progress over time. Specifically, midwives supported reported pushing sensations without insisting on examinations. Caution was occasionally expressed in distinguishing between irresistible and forced pushing. Across multiple contractions, midwives watched and waited for alignment of sensations with signs of descent. Where signs of progress were absent over time, examinations were treated as clinically indicated.DiscussionThus, a complex interplay of women's sensations and midwifery expertise produced care. Compared to past research, our analysis demonstrates increased validation of embodied experience in contemporary midwife‐led practice. However, uncertainty still requires navigation through collaborative work. We evidence how this navigation is accomplished in real‐time interactions.

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Early pushing urge in labour and midwifery practice: A prospective observational study at an Italian maternity hospital

Cited by 7 publications

References 13 publications

Midwives' approaches to early pushing urge in labour

Midwives' approaches to early pushing urge in labour

Birth

Just go with your body? A conversation analytic study of the transition from first to second stage of labor in UK midwife‐led care

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