An Exploration of the Views and Experiences of Midwives Using Intermittent Auscultation of the Fetal Heart in Labor

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Abstract

OBJECTIVES:

To identify the experiences of midwives using intermittent auscultation of the fetal heart rate in labor.

DESIGN:

A qualitative descriptive study with a sample of 8 midwives, 3 from a DOMINO scheme and 5 from the labor ward at an Irish urban maternity unit. Data collection was through tape-recorded semistructured interviews. Data analysis involved transcription of the interviews verbatim and thematic analysis.

FINDINGS:

Three core themes were identified: vulnerability, the culture of the organization, and walking the tightrope. The findings suggest that the main challenges which inhibit midwives using intermittent auscultation is the lack of professional guidelines, inconsistency in documentation, and working in a biomedical model of care. The participants also identified that midwives practicing in a midwifery social model of care have more confidence and use midwifery skills to support the use of intermittent auscultation.

CONCLUSIONS:

The findings suggest working within a midwifery social model of care facilitates the use of intermittent auscultation. Guidelines and education on the explicit use of intermittent auscultation need to be made accessible to midwives. Midwives believed that women could promote the use of intermittent auscultation through their own education on monitoring fetal heart rate options in labor.

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