Midwives’ experiences of Shoulder Dystocia and investigation of its incidence rate: An exploratory sequential mixed methods study
- Publication Type:
- Thesis
- Issue Date:
- 2022
Open Access
Copyright Clearance Process
- Recently Added
- In Progress
- Open Access
This item is open access.
𝗜𝗻𝘁𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝗼𝗻
Shoulder dystocia (SD) is known as one of the most traumatic birth experiences for midwives. Experience of a traumatic birth such as SD may cause emotional disturbances or in severe cases, mental health disorders for clinicians. Evidence is limited on the professional behavioural consequences for midwives who experience births complicated by SD. This thesis explored the experiences of midwives regarding SD as well as the incidence and trends of SD, its risk factors and outcomes.
𝗠𝗲𝘁𝗵𝗼𝗱𝘀
A two-phase sequential exploratory mixed methods study was conducted. The first phase included a qualitative descriptive study, and the second phase was a retrospective medical record review using de-identified data from one tertiary referral hospital in New South Wales (NSW), Australia over the period 2013-2018.
𝗥𝗲𝘀𝘂𝗹𝘁𝘀
For the first phase, a total of 25 midwives participated in the study. Midwives viewed SD as a traumatic birth associated with panic and anxiety. Following the event, the pathways of thinking and practising were not similar among all midwives. Fear of repetition of the incident and negative thoughts after the experience shifted some midwives towards catastrophic thinking and hypervigilant behaviours. However, for some other midwives, SD was viewed as an opportunity to grow and to actualise their potential midwifery skills. Results from the second phase of the study showed that the overall incidence of SD was 6% among live births. Diagnosis of mild SD showed an increasing trend from 2013 to 2018. Shoulder dystocia was significantly associated with some antenatal and intrapartum risk factors, including post-term pregnancy, maternal pre-existing diabetes/ Gestational Diabetes Mellitus, labour induction/ augmentation and duration of second stage of labour (more than two hours). The main maternal and neonatal adverse outcomes associated with SD were higher rate of postpartum haemorrhage, APGAR score< 7 at the 1st and 5th minute, and higher rates of neonatal resuscitation and admission to Neonatal Intensive Care Unit.
𝗥𝗲𝘀𝘂𝗹𝘁𝘀
This study demonstrated that midwives’ emotions (from previous experiences) can affect how they perceive normal birth, how they practise at birth and how they diagnose SD. The findings highlighted the need for further workplace and collegial support. In addition, the increasing trend of SD is an alarm signal that suggests provision of further supports for midwives who may frequently be exposed to SD-complicated births are necessary.
Please use this identifier to cite or link to this item: