Get access

Midwives’ Verbal Support of Nulliparous Women in Second-Stage Labor

Authors


  • The authors report no conflict of interest or relevant financial relationships.

Correspondence

Noelle Borders, CNM, MSN, Department of Obstetrics and Gynecology, Midwifery Division, MSC10 5580 1, University of New Mexico, Albuquerque NM 87131. aborders@salud.unm.edu

ABSTRACT

Objective

To describe how nurse-midwives verbally support nulliparous women during second-stage labor and document specific details of each second stage.

Design

Descriptive qualitative study.

Setting

A university hospital labor and delivery unit in the southwestern United States.

Participants

Nulliparous women (n = 14) older than age 18 and their attendant midwives (n = 9).

Methods

A single research midwife observed the entire second stage of each woman and used a standardized data collection form to record spontaneous or directed pushing, position changes, open and closed glottis pushing. A digital audio recorder was employed to capture verbal communication between the midwife and laboring woman. The research midwife and two qualitative experts employed content analysis to analyze the audio transcripts and identify categories of verbal support.

Results

Analysis revealed four categories of verbal support: affirmation, information sharing, direction, and baby talk. The vast majority of verbal communication by nurse-midwives consisted of affirmation and information sharing. Nurse-midwives gave direction for specific reasons. Women pushed spontaneously the majority of the time, regardless of epidural use.

Conclusion

Nurse-midwives use a range of verbal support strategies to guide the second stage. Directive support was relatively uncommon. Most verbal support instead affirmed a woman's ability to follow her own body's lead in second-stage labor, with or without epidural.

Get access to the full text of this article

Ancillary