Midwives Experience's of 'Vulnerability' When Using Intermittent Auscultation
Karen Hill
Trinity College Dublin
Karen Hill RGN, RM, MSc, Ba, HDip, Dip.Clinical Tutor in Midwifery, Trinity College DublinKaren currently works as a clinical tutor in Trinity College Dublin since 2013. Previously she has worked as a Clinical Midwife Manager in the Coombe Women and Infants University Hospital. She has more than a decade of clinical experience in Midwifery, in particular antenatal and intrapartum care. She completed her MSc in Midwifery in 2011, with a study regarding midwives experiences of using intermittent auscultation. Prior to training as a midwife, Karen trained and worked as a general nurse in the Adelaide and Meath Hospital, incorporating the National Children's Hospital, Tallaght.
Abstract
Background: Intermittent auscultation is the recommended method of monitoring the fetal heart rate in labour for low risk pregnancies. The use of intermittent auscultation (IA) has been in demise since the introduction of the... [ view full abstract ]
Background: Intermittent auscultation is the recommended method of monitoring the fetal heart rate in labour for low risk pregnancies. The use of intermittent auscultation (IA) has been in demise since the introduction of the electronic cardiotocograph (CTG) in the 1960's. It was believed that the CTG would decrease perinatal morbidity and mortality rates, however, this belief has not reached those expectations. Evidence now exists to demonstrate the use of the CTG as opposed to IA of the fetal heart rate for low risk labours increases instrumental birth and caesarean section rates.
Aims and Objectives: To describe midwives views and experiences of using IA of the fetal heart rate in labour. This presentation focuses on some of the barriers identified by the participating midwives using IA under the theme of 'Vulnerability'.
Method: A qualitative descriptive study was conducted in an Irish urban obstetric-led maternity unit. A non-probability purposive sample consisted of eight midwives. Data was collected through semi-structured interviews with thematic analysis resulting in 3 main themes. Ethical approval was received from the participating research site and the author's institution.
Findings: This presentation focuses on the first theme, 'Vulnerability' with 4 subthemes. The subthemes identified the difficulties midwives face when practising IA. These are policies and guidelines, inconsistency in documentation, proof of the fetal heart rate and external validation of competency.
Conclusions and Implications: The lack of guidelines focusing primarily on IA prevents the use of this method for recording the fetal heart rate in low risk labours. It also contributes to inconsistent documentation which leaves midwives vulnerable to criticism. The promotion of IA through specific education such as clinical workshops, could provide midwives with the confidence and clarification they need to practice IA more frequently.
Authors
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Karen Hill
(Trinity College Dublin)
Topic Area
Maternity Care
Session
MC-1 » Maternity Care 1 (10:30 - Wednesday, 4th November, Lecture Theatre 0.32)
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