The midwives' management of the third stage of labour : an observational study.

Abstract

The third stage of labour is normally short but is not lacking in risk when considering that serious complications which may lead to severe morbidity and mortality for women may take place. No wander that debate continues to arise over the best way to deal with the third stage of labour. For this reason the aim of this study was to observe midwives' management of the third stage of labour. Such an aim was achieved by observing the midwives' practices during the third stage of labour, by considering carefully whether their practice reflects the literature and by investigating if any variations exist in the management of the third stage of labour. In this descriptive, non-experimental, small scale study a structured observation schedule was used for collecting data. Ten qualified midwives working at the labour ward were chosen by convenience sampling for this study and each midwife was observed managing the third stage of labour. Observations started with the crowning of the baby's head and ended five minutes after complete expulsion of the placenta and membranes. Findings suggested that variations amongst midwives do exist in certain aspects of third stage management. Such variations may be attributed to the gap between knowledge and practice as not all the midwives' practices during third stage management reflected the literature. On the other hand, this study revealed that certain aspects of third stage management are conforming and uniform among these same midwives. Finally, limitations of this study together with recommendations for clinical practice, education and research were discussed.