Artificial rupture of the membranes during labour

Abstract

Artificial Rupture of the Membranes (ARM) is considered a simple procedure; however it poses certain risks on the mother and fetus. This is why debate exists regarding its routine performance, if and how women are informed about it prior to its performance, and whether written informed consent is obtained before the procedure. For this reason the aim of the study was to observe midwives' practices in performing ARM during labour. Such aim was achieved by observing information giving and informed consent procedures prior ARM, and by observing the midwife's role in this area of practice. For this descriptive, non-experimental, small scale study, a structured observation schedule was devised for data collection. Ten qualified midwives working at the labour ward were conveniently chosen as participants for this study and each midwife was observed to perform ARM on women in labour. Observations started from the instance that the women were told about ARM and ended after the procedure was performed and the women were resettled. Findings suggested that similarities in practice exist as regards inadequate information-giving and the absence of written informed consent procedures prior to ARM. Variations between midwives also existed as not all midwives reflected the literature while performing ARM. This can be related to the conflict between what midwives are originally taught in the classroom and the practice they observe from other colleagues on the clinical area. Finally, the limitations of this study together with recommendations for clinical practice, education and research were discussed.