Watching and Sensing the Subtlety: A Hermeneutic Phenomenolohgical Exploration and Description of Independent Midwives' Experiences Supporting Women's Physiological Third Stages of Labour during Home Births

This source preferred by Jane Fry

Authors: Fry, J.

Start date: 10 June 2009

Background:As a result of a risk-entrenched approach to physiological support of the third stage, it has been almost replaced by a universal strategy of active management of labour. Despite the limited availability of physiological management, women still readily choose this option as an integral part of their labour. Support of physiological third stage is however, becoming a dying art. There is scant evidence of what is considered to be the essence of support for women's physiological third stages of labour. It was proposed that an exploration of the lived experiences of independent midwives could elucidate a wealth of experience of supporting women's third stages. The sample selection has been focused exclusively on five independent midwives across England and their practice during home births in an endeavour to elucidate a wealth of experience unfettered by policies and guidelines.

Method:A qualitative research approach utilising an interpretative phenomenological methodology was selected. It was proposed that this approach wold enable a breadth and depth of data to capture the essence of supporting women's physiological third stages. Data collection was via semi-structured interviews. Essential themes elucidated from the transcribed data were interpreted through the hemeneutic circle creating a whole and parts of the essense of independent midwives' support of women's physiological third stage of labour during home birth.

Results: The emerging essence of support has been interpreted as a period of watchful waiting where the midwife enables the woman to adjust to the birth of her baby, creates an awareness of the forthcoming placenta, and supports the active physiological process by non-interference and confidence in the process.

Discussion:It is anticipated that the knowlege gleaned from this study will help enable midwives to support women choosing to have a physiological third stage and add to the body of knowledge of what constitutes the parameters of normality within a physiological third stage of labour.

Conclusion: A dearth in the knowledge and published text surrounding how women are supported to have a third stage has provided the rationale for research. It is proposed that the interpretive phenomenological approach chosen has illuminated the essence of independent midwives' support and will improve the existing knowledge of physiological care of women's third stages of labour

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