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Managing Labor Using Partograms with Different Action Lines: A Prospective Study of Women's Views

Authors

  • Tina Lavender MSc,

    1. Tina Lavender is a Research Midwife at Liverpool Women's Hospital; Akhtar Wallymahmed is Principal Lecturer at Liverpool John Moores University; and Stephen Walkinshaw is Consultant in Feto-Maternal Medicine, Liverpool Women's Hospital, Liverpool, United Kingdom.
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  • Akhtar H Wallymahmed MA, BA(Hon),

    1. Tina Lavender is a Research Midwife at Liverpool Women's Hospital; Akhtar Wallymahmed is Principal Lecturer at Liverpool John Moores University; and Stephen Walkinshaw is Consultant in Feto-Maternal Medicine, Liverpool Women's Hospital, Liverpool, United Kingdom.
    Search for more papers by this author
  • Stephen A Walkinshaw BSc, MD, MRCOG

    1. Tina Lavender is a Research Midwife at Liverpool Women's Hospital; Akhtar Wallymahmed is Principal Lecturer at Liverpool John Moores University; and Stephen Walkinshaw is Consultant in Feto-Maternal Medicine, Liverpool Women's Hospital, Liverpool, United Kingdom.
    Search for more papers by this author

Address correspondence to Tina Lavender, Liverpool Women's Hospital, Crown Street, Liverpool, Merseyside, L8 7SS, United Kingdom.

Abstract

Background: The precise timing of medical intervention for women in prolonged labor is the subject of considerable debate. The partogram action line is a tool to assist practitioners in the correct diagnosis of prolonged labor. Despite its widespread use, the precise timing of the action line has not been rigorously studied, and women's views have rarely been sought. The aim of this study was to assess the effect on maternal satisfaction of managing labor using partograms with action lines drawn at 2, 3, or 4 hours to the right of the alert line. Methods: As part of a large pilot randomized controlled trial, women's views were explored using a specifically designed questionnaire that was completed by 615 primiparas 2 days after giving birth. The quantifiable data were analyzed by comparing means using ANOVA followed by the Scheffe test. Results: Women in the 2-hour arm were significantly more satisfied than those in the other two arms ( p < 0.001), despite having the most obstetric intervention. Conclusions: For women in prolonged labor, obstetric intervention can be an acceptable or even favorable option. Midwives and obstetricians need to provide labor management that takes into account the preferences of the women to whom they give care.

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