Abstract
Background
Restriction of food and fluids during labour increases women’s discomfort, anxiety
and stress which are associated with obstruction of the normal process of labour.
Whilst research evidence and clinical guidelines recommend that normal uncomplicated
labouring women should not be limited in their oral intake during labour, some midwives
continue to restrict or discourage women’s oral intake. To promote best practice,
it is important to understand the influencing factors which affect midwives’ decision-making
processes.
Objective
This study aimed to investigate the influences that affect midwifery practice regarding
oral food and fluid intake for low-risk labouring women.
Design
An interpretive descriptive approach employed 12 semi-structured interviews with registered
midwives with current labour and birthing experience in Australia. Data was analysed
using thematic analysis.
Findings
Three themes were identified: midwives’ knowledge and beliefs; work environment and
women’s expectations of care. Midwives’ practice was affected by their knowledge and
values developed from professional and personal experiences of labour, their context
of practice and work environment, the clinical guidelines, policies and obstetric
control, and women’s choice and comfort.
Conclusion
This study indicates that midwives’ decision-making in relation to women’s oral nutrition
during labour is multifaceted and influenced by complicated environments, models of
care, and power relations between doctors and midwives, more so than clinical guidelines.
It is important for midwives to be aware of factors negatively influencing their decision-making
processes to enable autonomy and empowerment in the provision of evidence-based care
of labouring women.
Keywords
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Article info
Publication history
Published online: November 30, 2019
Accepted:
November 14,
2019
Received in revised form:
November 14,
2019
Received:
November 28,
2018
Identification
Copyright
© 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
