Midwifery care in the first stage of labour

Abstract

The above quotations reflect the wide range of feelings expressed by mothers about their labours. This chapter is written with the intention of exploring the way in which good midwifery practice can contribute to a positive experience of labour for the mother, enabling her to enter parenthood with a sense of achievement and a degree of confidence. It is of course accepted that this outcome cannot be considered in isolation, and therefore the chapter begins by acknowledging that a safe outcome for the mother and baby is the primary objective of care in labour. Having established these two objectives, the chapter goes on to review current midwifery practice in the first stage of labour and the extent to which it contributes to these outcomes. In recent years admission procedures, including perineal shaving and the administration of enemas, have been criticised by consumer groups, and these will be considered in detail. At present, the organisation of maternity care in hospitals is being reviewed in many areas, and this chapter considers the way in which different patterns of care affect communication between the woman and those caring for her.

It was a marvellous experience. I had the very best treatment for myself, my husband and my baby. Ten out of ten for help and care.

Now, six months after my labour, I still feel angry and distressed when I think about it. I have been left with an overwhelming sense of failure.

(Parents magazine survey 1983)