Abstract
Background
Many high-income countries have seen an increase in severe perineal trauma. Teaching
strategies and conditions for learning during the active second stage of labour are
scarcely described.
Aim
To describe midwifery preceptors and midwifery students’ experiences’ of teaching
and learning how to manage the second stage of labour, with the specific aim of preventing
severe perineal trauma.
Methods
A qualitative study with focus group discussions and individual in depth-interviews
with preceptor midwives (n = 23) and student midwives (n = 10). Data were analysed
by qualitative content analysis.
Results
“A complex and demanding situation with mutual need for feedback, reflection and safety”
was the overall theme describing the conditions. Three sub-themes were identified.
“Adapting to a unique situation” refers to the difficulty of teaching and learning
the aspects needed to prevent severe perineal trauma, and to provide care during this
stage. “Hindering and limiting circumstances” describes teaching strategies that were
perceived negatively, and how midwifery students tried to adapt to the preceptors
rather than the birthing women. “A trustful and communicative relationship” describes
the importance of the relationship between the student and the preceptor, where communication
was a central, but not obvious part.
Conclusion
An increased awareness among preceptors is needed to optimize teaching strategies,
enabling the students to focus on learning the art of the second stage of labour;
supporting the woman, preventing severe perineal trauma and ensuring the safety of
the unborn baby. Future research should address how existing prevention models can
include training to increase preceptors’ confidence in teaching.
Abbreviations:
SPT (Severe perineal trauma, i.e., perineal injuries affecting the anal sphincter muscle complex), FGD (Focus group discussions)Keywords
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Article info
Publication history
Published online: May 12, 2022
Accepted:
May 6,
2022
Received in revised form:
May 6,
2022
Received:
January 20,
2022
Identification
Copyright
© 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
