Document Type
Journal Article
Publication Title
Women and Birth
Volume
37
Issue
1
First Page
229
Last Page
239
PubMed ID
37867094
Publisher
Elsevier
School
School of Nursing and Midwifery
RAS ID
62378
Funders
Australian Government Research Training Program Scholarship / Edith Cowan University
Abstract
Background and problem: During childbirth, one of the most common diagnoses of pathology is ‘failure to progress’, frequently resulting in labour augmentation and intervention cascades. However, failure to progress is poorly defined and evidence suggests that some instances of slowing, stalling and pausing labour patterns may represent physiological plateaus. Aim: To explore how midwives conceptualise physiological plateaus and the significance such plateaus may have for women's labour trajectory and birth outcome. Methods: Twenty midwives across Australia participated in semi-structured interviews between September 2020 and February 2022. Constructivist grounded theory methodology was applied to analyse data, including multi-phasic coding and application of constant comparative methods, resulting in a novel theory of physiological plateaus that is firmly supported by participant data. Findings: This study found that the conceptualisation of plateauing labour depends largely on health professionals’ philosophical assumptions around childbirth. While the Medical Dominant Paradigm frames plateaus as invariably pathological, the Holistic Midwifery Paradigm acknowledges plateaus as a common and valuable element of labour that serves a self-regulatory purpose and results in good birth outcomes for mother and baby. Discussion: Contemporary medicalised approaches in maternity care, which are based on an expectation of continuous labour progress, appear to carry a risk for a misinterpretation of physiological plateaus as pathological. Conclusion: This study challenges the widespread bio-medical conceptualisation of plateauing labour as failure to progress, encourages a renegotiation of what can be considered healthy and normal during childbirth, and provides a stimulus to acknowledge the significance of childbirth philosophy for maternity care practice.
DOI
10.1016/j.wombi.2023.10.003
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Weckend, M., McCullough, K., Duffield, C., Bayes, S., & Davison, C. (2024). Failure to progress or just normal? A constructivist grounded theory of physiological plateaus during childbirth. Women and Birth, 37(1), 229-239. https://doi.org/10.1016/j.wombi.2023.10.003