Summary
Objective
Vaginal examinations (VEs) in labour are a routine part of intrapartum care. Current
UK guidelines recommend that VEs are offered to women at regular intervals of not
less than 4 h and only performed when justifiably necessary. However, justification may be interpreted
differently by different midwives. This study aimed to investigate (i) the number
of VEs performed in relation to length of labour and (ii) the reasons given by midwives
for performing the VE.
Methods
This study recruited a group of women (n = 144) admitted in either spontaneous labour or for induction of labour from one NHS
hospital in Scotland. The number of VEs performed, the reason provided by the midwife
for its need and the length of labour were all recorded.
Findings
The number of VEs carried out (mean 2.9, SD 1.5, range 1–7) increased as length of
time in labour in hospital increased. Approximately half the sample (52%) had 3 or
more VEs during labour. Almost 70% of women had more VEs than expected when the criteria
of 4 hourly VEs was applied. The most common reason given by midwives for performing
a VE was to assess labour progress and to assess the commencement of labour.
Conclusions
Despite maternity care policy to limit interventions in normal labour, we found that
a substantial number of women received more VEs than was consistent with adherence
to guidelines. However, until further research is conducted to validate other measures
of labour progress, the number of VEs undertaken during labour is unlikely to decrease.
Keywords
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Article info
Publication history
Published online: March 07, 2012
Accepted:
February 7,
2012
Received in revised form:
January 31,
2012
Received:
December 16,
2011
Identification
Copyright
© 2012 Australian College of Midwives. Published by Elsevier Inc. All rights reserved.
