Speeding up labour: what do women think?
Posted on: 22 March 2023
Researchers from the School of Nursing and Midwifery say that clinical guidelines and hospital policies for speeding up labour must change to be informed by research that includes women’s views and experiences, Their research is published in the journal ‘Midwifery’.
Researchers from the School of Nursing and Midwifery at Trinity say that clinical guidelines and hospital policies for speeding up labour must change to be informed by research that includes women’s views and experiences. Their call for change comes on the back of a qualitative evidence synthesis published by their team recently in the journal ‘Midwifery’.
Augmentation of labour with synthetic oxytocin (AOL) is an intervention that aims to accelerate women’s labour – after the onset of spontaneous labour - by making their contractions longer, stronger, and more frequent; and it is usually performed with an oxytocin drip after spontaneous or artificial rupture of the membranes.
Although AOL should only be performed when there is a clear indication of need, the World Health Organization has raised concerns about its overuse* (see Editor’s notes below). In countries like Norway or Finland, for example, more than 50% of first-time mothers have their labour accelerated.
This research aimed to explore women’s views and experiences of AOL and included 25 studies across 14 countries, conducted between 2004 and 2021.
- Women narrated their experiences of having their labour speeded up as atypically painful and described AOL, fundamentally, in negative terms such as: ‘unnatural’, ‘traumatic’ and ‘disempowering’.
- The decision to accelerate women’s labour was often performed without their informed consent.
Silvia Alòs, PhD student at the School of Nursing and Midwifery and lead author of the study, said:
‘Perhaps another surprising finding was that the vast majority of studies that we found did not focus specifically on AOL. However, women wanted to and talked spontaneously about AOL when recalling their childbirth experiences, suggesting that this was relevant for them. It is striking that AOL, one of the most commonly performed interventions that women may undergo during childbirth, has been given very little attention by researchers. Basically, we have been using AOL for more than 50 years without asking women their opinion about it.’
‘Books, data sheets and healthcare providers usually describe that AOL causes similar contractions to those observed in spontaneous labour, but that is not what women recounted.’
Commenting on their findings in relation to informed consent, Silvia Alòs concluded:
‘Access to information is key. When discussing the risks of AOL with women, healthcare providers should incorporate the potential implications that AOL may have on their childbirth experience. Looking ahead, we hope that clinical guidelines and hospital policies on AOL benefit from considering our findings.’
MORE: You can read the full paper: Women’s views and experiences of augmentation of labour with synthetic oxytocin infusion. A qualitative evidence synthesis, here