First-time mothers' expectations and experiences of rupture of membranes

Background: Previous early labour research has provided insights into first-time mothers’ concerns about labour onset and hospital admission in early labour. However, there is currently little information regarding women’s... [ view full abstract ]

Background: Previous early labour research has provided insights into first-time mothers’ concerns about labour onset and hospital admission in early labour. However, there is currently little information regarding women’s perspectives of rupture of membranes (RoM). The aim of this research was to explore women’s expectations and experiences of RoM at term, and their views on the potential use of reagent pads for detecting amniotic fluid.

Method: A qualitative study with thematic analysis. Following Ethics Committee approvals, informed consent was obtained from participants. The sample comprised 17 healthy women with straightforward pregnancies expecting their first child (Group A), invited to participate in one focus group or interview during pregnancy and the postpartum and 8 first-time mothers who experienced spontaneous RoM (Group B), invited to participate in one focus group or interview postpartum. A topic guide was used during focus groups and interviews, which were digitally recorded and transcribed verbatim. Themes were agreed by all authors to support rigour, trustworthiness and reliability.

Findings:  17 women contributed views during pregnancy and 21 in the postpartum.  Three overarching themes emerged from analysis of data collected during pregnancy and the postpartum: a) uncertainty in how, when and where membranes may rupture; b) information provided and expected; c) confirmation of rupture of membranes. Views about the potential use of reagent pads varied, including the possibilities that they may be helpful for some women but increase anxiety for others and also contribute to a more medicalised approach to labour.

Discussion and Conclusion: This study offers novel insights into women's expectations and experiences of rupture of membranes. Women were interested in access to facts about RoM, such as characteristics of liquor; volume and the probability of RoM at term.  This information and that related to the sensation of ROM should be included in antenatal education and other evidence based information sources accessed by childbearing women.  Use of a reagent pad has been recommended to avoid more invasive approaches to confirmation of ROM but further research is required prior to incorporation into routine use for women with straightforward pregnancies.