Women's Views of Second-Stage Labor as Assessed by Interviews and Videotapes

Authors

  • Susan McKay R.N., Ph.D.,

    Corresponding author
    1. Susan McKay is Professor of Nursing at the University of Wyoming and a psychologist in private practice in Laramie, Wyoming.
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  • Teri Barrows R.N., M.S.,

    1. Teri Barrows is a research associate with the Second Stage Labor Project, University of Wyoming.
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  • Joyce Roberts C.N.M., Ph.D., F.A.A.N.

    1. Joyce Roberts is Professor of Nursing and Head, Department of Maternal Child Nursing, at the University of Illinois at Chicago.
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  • This work was funded by Grant No. 1 R01 NR 01.500-03, National Center for Nursing Research, NIH, DHHS; the ICEA Virginia Larsen Research Fund; and a University of Wyoming Challenge Grant.

Address correspondence to S. McKay at U. Wyoming, P.O. Box 3065, Laramie, WY82701.

Abstract

ABSTRACT: Twenty women were selected from public and private maternity services and interviewed by nurses and nurse-midwives on a research team. The women were shown videotapes of their second-stage labors that for 15 of them had been recorded by 2 other members of the research team. Four videos were provided by mothers who had had home births and one from a mother whose birth was filmed at a birth center. The interviews were analyzed for major themes; the theme reported here is women's experiences of pushing. Women reported wide variations in sensations during the second stage. Whereas 9 of 16 women expressed feelings of relief or pressure and stretching, 7 described pushing as painful, miserable, or horrible. Thirteen of 19 women had well defined urges to push, 1 had an intermittent urge, and 5 had no urge. Women often felt unprepared for the sensations and work of second-stage labor, and caregivers' instructions commonly did not seem to be in synchrony with physiological responses. We conclude that childbirth educators and caregivers must prepare women more realistically for the second stage. They would be more effective if they responded to maternal behavior, rather than giving arbitrary instructions about pushing.

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