Document Type
Journal Article
Publication Title
Birth
PubMed ID
38800984
Publisher
Wiley
School
School of Nursing and Midwifery
RAS ID
71466
Funders
Edith Cowan University / Australian Government
Abstract
Background: Diagnoses of labor dystocia, and subsequent labor augmentation, make one of the biggest contributions to childbirth medicalization, which remains a key challenge in contemporary maternity care. However, labor dystocia is poorly defined, and the antithetical concept of physiological plateaus remains insufficiently explored. Aim: To generate a definition of physiological plateaus as a basis for further research. Methods: This qualitative study applied grounded theory methods and comprised interviews with 20 midwives across Australia, conducted between September 2020 and February 2022. Data were coded in a three-phase approach, starting with inductive line-by-line coding, which generated themes and subthemes, and finally, through axial coding. Results: Physiological plateaus represent a temporary slowing of one or multiple labor processes and appear to be common during childbirth. They are reported throughout the entire continuum of labor, typically lasting between a few minutes to several hours. Their etiology/function appears to be a self-regulatory mechanism of the mother-infant dyad. Physiological plateaus typically self-resolve and are followed by a self-resumption of labor. Women with physiological plateaus during labor appear to experience positive birth outcomes. Discussion: Despite appearing to be common, physiological plateaus are insufficiently recognized in contemporary childbirth discourse. Consequently, there seems to be a significant risk of misinterpretation of physiological plateaus as labor dystocia. While findings are limited by the qualitative design and require validation through further quantitative research, the proposed novel definition provides an important starting point for further investigation. Conclusion: A better understanding of physiological plateaus holds the potential for a de-medicalization of childbirth through preventing unjustified labor augmentation.
DOI
10.1111/birt.12843
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). Physiological plateaus during normal labor and birth: A novel definition. Birth. Advance online publication. https://doi.org/10.1111/birt.12843