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Women's perception of intrapartal care in relation to WHO recommendations

Authors

  • Ann-Kristin Sandin-Bojö,

    1. Authors: Ann-Kristin Sandin-Bojö, PhD, RNT, RM, Senior Lecturer, Department of Nursing, Karlstad University, Karlstad, Sweden; Bodil Wilde Larsson, PhD, RNT, Professor, Department of Nursing, Karlstad University, Karlstad, Sweden; Marie-Louise Hall-Lord, PhD, RNT, Professor, Department of Nursing, Gjovik University College, Gjovik, Norway and Associate Professor, Department of Nursing, Karlstad University, Karlstad, Sweden
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  • Bodil Wilde Larsson,

    1. Authors: Ann-Kristin Sandin-Bojö, PhD, RNT, RM, Senior Lecturer, Department of Nursing, Karlstad University, Karlstad, Sweden; Bodil Wilde Larsson, PhD, RNT, Professor, Department of Nursing, Karlstad University, Karlstad, Sweden; Marie-Louise Hall-Lord, PhD, RNT, Professor, Department of Nursing, Gjovik University College, Gjovik, Norway and Associate Professor, Department of Nursing, Karlstad University, Karlstad, Sweden
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  • Marie-Louise Hall-Lord

    1. Authors: Ann-Kristin Sandin-Bojö, PhD, RNT, RM, Senior Lecturer, Department of Nursing, Karlstad University, Karlstad, Sweden; Bodil Wilde Larsson, PhD, RNT, Professor, Department of Nursing, Karlstad University, Karlstad, Sweden; Marie-Louise Hall-Lord, PhD, RNT, Professor, Department of Nursing, Gjovik University College, Gjovik, Norway and Associate Professor, Department of Nursing, Karlstad University, Karlstad, Sweden
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Ann-Kristin Sandin-Bojö, Department of Nursing, Karlstad University, S-651 88 Karlstad, Sweden. Telephone: 00 467 002 492.
E-mail: fia.bojo@kau.se

Abstract

Background.  The aim of intrapartal care in normal birth is to achieve a healthy mother and child using the least possible number of interventions that is compatible with safety.

Aim.  The aims of this study were to elucidate women’s perception of intrapartal care and women’s perceptions of normal birth.

Methods.  A questionnaire developed from the WHO’s recommendations for care in normal birth was answered by 138 (response rate 66·0% Swedish women. The women were asked to evaluate items in two ways: their perceived reality of care received and the subjective importance of each item.

Results.  Most women reported receiving care in the category (A) practices that are good and should be encouraged. However, women to a minor degree reported assessment for physical health, enquiring about support needs and pain assessment on admission. Many women received electronic foetal monitoring, repeated vaginal examinations, oxytocin augmentation and suturing after birth which fall under the category (B) practices that are harmful, (C) insufficient evidence exists and (D) practices frequently used inappropriately. The women who reported ‘Yes’ for perceived reality also reported high subjective importance for those items regardless of category A–D. Eighty-four per cent of the women perceived that they had a normal delivery.

Conclusion.  The result suggests that women have great trust that the care midwives give them is the best care. Midwives, therefore, have an ethical responsibility to keep themselves informed about the best evidence-based care and to implement critical reviewing of their practice as part of continuing professional development. The women’s perceptions of a normal birth allows for a wide range of interventions.

Relevance for clinical practice.  The result emphasises the importance of midwives’ knowledge of evidence-based care and how to implement this into practice. Further research should include elucidation of the meaning of normal childbirth to childbearing women.

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