Midwives’ views and attitudes of amniotomy to accelerate spontaneous onset of labour

Abstract

Amniotomy, through which the amniotic membranes are intentionally ruptured, is an obstetric intervention performed during labour. The aim of this study was to explore midwives’ views and attitudes of amniotomy to accelerate spontaneous onset of labour. The objectives sought to explore midwives’ attitudes regarding amniotomy performed to accelerate spontaneous onset of labour, to identify the midwives’ views on the advantages and disadvantages of this procedure, and to outline the midwives’ views on the ethical implications when performing amniotomy to accelerate spontaneous onset of labour. A descriptive survey design was chosen for the study. Data was collected through a self-designed questionnaire using open- and closed-ended questions. The sample consisted of 30 midwives (N=40, 75%) working at the Delivery-Suite of the local State hospital, selected through convenience sampling. The data was analysed via Microsoft Excel, using both descriptive statistics and content analysis, and was presented in diagrammatic graphs and tables. The findings suggested that, even though amniotomy is a commonly performed procedure, most midwives do not perform this intervention during spontaneous labour when not indicated. Furthermore, the risks of complications following amniotomy were considered to be minimal. All the participants emphasised informed choice and gaining consent prior to performing the procedure. However, information giving was not always consistent among the midwives. The midwives also believed that women do not always have adequate knowledge of amniotomy prior to the procedure. Similar to other studies, the participants agreed that amniotomy is performed in situations as prolonged labour, compromised fetal condition, and locally, prior to administering pharmacological pain relief. Strengths and limitations were outlined. Several recommendations for practice, education, and further research were proposed, including information about amniotomy during antenatal education, and continuous professional development of midwives with regards to the latest literature on amniotomy. In conclusion, recommendations were put forward for further research using a qualitative approach to study the experiences and perspectives of both midwives and mothers concerning amniotomy.