Swedish midwives’ experiences of collegial midwifery assistance during the second stage of labour: A qualitative study

Tern, Helena; Edqvist, Malin; Ekelin, Maria; Dahlen, Hannah; Rubertsson, Christine

doi:10.1016/j.wombi.2022.03.003

Cited by 3 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, 61% completely agreed that they felt confident and 56% were positive. This is in contrast to the findings from the previous qualitative study, where midwives sometimes reported situations where they thought this intervention was not beneficial for themselves or for the birthing woman 16 . One possible explanation for the different results might be the difference in study design.…”

Section: Discussioncontrasting

confidence: 99%

“…The duration of the second midwife's presence could similarly be an important factor as a longer time gives the second midwife the opportunity to learn about the woman giving birth, the birth taking place, and the primary midwife's line of reasoning. This is in accordance with the previous qualitative study, 16 that found that it was difficult for the second midwife to contribute with practical assistance when arriving very late in the final phase of the second stage of labor when only a few contractions were left. Practical skills have previously been found to be highly valued and associated with professional identity, 8 which may explain why expectations of assistance seem to be “task‐oriented” to a large extent.…”

Section: Discussionsupporting

confidence: 93%

“…Our results showed that unfavorable experiences, such as the second midwife taking too much space (i.e., intervened more than expected), or the primary midwife feeling disturbed, stressed, or scrutinized, were each agreed with to some extent in two to twelve percent of births. In addition, as shown in the focus group study that evaluated midwives' experiences of the practice, 16 some of the experienced midwives did not see the necessity of always having a colleague present and they may have felt that their independence and competence were being challenged. This could especially be the case when they have traditionally been trained in a context that promoted working autonomously in normal births 9 .…”

Section: Discussionmentioning

confidence: 99%

“…Opportunities for collaboration may arise, 8 as may possible benefits such as knowledge exchange and support in facilitating a normal birth 15 . However, potential unintended side effects for the primary midwife may also occur, and these can include a feeling of loss of control, one's practice being scrutinized, and loss of autonomy and independence compared to working alone 16 . A recent focus group study evaluating midwives' experiences of the intervention 16 showed that various factors affect how this clinical practice is experienced.…”

Section: Introductionmentioning

confidence: 99%

“…15 However, potential unintended side effects for the primary midwife may also occur, and these can include a feeling of loss of control, one's practice being scrutinized, and loss of autonomy and independence compared to working alone. 16 A recent focus group study evaluating midwives' experiences of the intervention 16 showed that various factors affect how this clinical practice is experienced. Some of the factors were the number of years they have spent in the profession, the time the second midwife is present in the birthing room, if there has been the opportunity to plan the assistance and the role of the second midwife ahead of time.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Primary midwives' experiences of collegial midwifery assistance during the active second stage of labor: Data from the Oneplus trial

Tern

Edqvist

Ekelin

et al. 2023

Birth

Self Cite

View full text Add to dashboard Cite

BackgroundCollegial midwifery assistance during the active second stage of labor that involves a second midwife being present has been shown to reduce severe perineal trauma (SPT) by 30%. The aim of this study was to investigate primary midwives' experiences of collegial midwifery assistance with the purpose of preventing SPT during the active second stage of labor.MethodsThis study uses an observational design with data from a multicenter randomized controlled trial (Oneplus). Data consist of clinical registration forms completed by the midwives after birth. Descriptive statistics as well as univariable and multivariable logistic regression were used to analyze the data.ResultsThe majority of the primary midwives felt confident (61%) and were positive (56%) toward the practice. Midwives with less than 2 years' work experience were more likely to completely agree they felt confident (aOR 9.18, 95% CI: 6.28–13.41) and experience the intervention as positive (aOR 4.04, 95% CI: 2.83–5.78) than those with over 20 years' work experience. Factors such as duration of time spent in the birthing room by the second midwife, opportunity for planning and if the second midwife provided support were further associated with the primary midwife's experience of the practice as being positive.ConclusionsOur findings indicate that having a second midwife present during the active second stage of labor was an accepted practice, with the majority of primary midwives feeling confident and positive toward the intervention. This was especially pronounced among midwives with less than 2 years' work experience.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Primary midwives' experiences of collegial midwifery assistance during the active second stage of labor: Data from the Oneplus trial

Tern

Edqvist

Ekelin

et al. 2023

Birth

Self Cite

View full text Add to dashboard Cite

show abstract

Women’s experiences of being assisted by two midwives during the active second stage of labour: Secondary outcomes from the Oneplus trial

Tern,

Rubertsson,

Ekelin

et al. 2024

Sexual & Reproductive Healthcare

View full text Add to dashboard Cite

Midwives’ experiences of professional learning when practicing collegial midwifery assistance during the active second stage of labour: data from the oneplus trial

Tern,

Edqvist,

Rubertsson

et al. 2024

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Learning is a lifelong process and the workplace is an essential arena for professional learning. Workplace learning is particularly relevant for midwives as essential knowledge and skills are gained through clinical work. A clinical practice known as ‘Collegial Midwifery Assistance’ (CMA), which involves two midwives being present during the active second stage of labour, was found to reduce severe perineal trauma by 30% in the Oneplus trial. Research regarding learning associated with CMA, however, is lacking. The aim was to investigate learning experiences of primary and second midwives with varying levels of work experience when practicing CMA, and to further explore possible factors that influence their learning. Methods The study uses an observational design to analyse data from the Oneplus trial. Descriptive statistics and proportions were calculated with 95% confidence intervals. Stratified univariable and multivariable logistic regression analysis were performed. Results A total of 1430 births performed with CMA were included in the study. Less experienced primary midwives reported professional learning to a higher degree (< 2 years, 76%) than the more experienced (> 20 years, 22%). A similar but less pronounced pattern was seen for the second midwives. Duration of the intervention ≥ 15 min improved learning across groups, especially for the least experienced primary midwives. The colleague’s level of experience was found to be of importance for primary midwives with less than five years’ work experience, whereas for second midwives it was also important in their mid to late career. Reciprocal feedback had more impact on learning for the primary midwife than the second midwife. Conclusions The study provides evidence that CMA has the potential to contribute with professional learning both for primary and second midwives, for all levels of work experience. We found that factors such as the colleague’s work experience, the duration of CMA and reciprocal feedback influenced learning, but the importance of these factors were different for the primary and second midwife and varied depending on the level of work experience. The findings may have implications for future implementation of CMA and can be used to guide the practice.

show abstract

Swedish midwives’ experiences of collegial midwifery assistance during the second stage of labour: A qualitative study

Cited by 3 publications

References 28 publications

Primary midwives' experiences of collegial midwifery assistance during the active second stage of labor: Data from the Oneplus trial

Primary midwives' experiences of collegial midwifery assistance during the active second stage of labor: Data from the Oneplus trial

Women’s experiences of being assisted by two midwives during the active second stage of labour: Secondary outcomes from the Oneplus trial

Midwives’ experiences of professional learning when practicing collegial midwifery assistance during the active second stage of labour: data from the oneplus trial

Contact Info

Product

Resources

About