Physiological plateaus during normal labor and birth: A novel definition.

Weckend, M; McCullough, K; Duffield, C; Bayes, S; Davison, C

Physiological plateaus during normal labor and birth: A novel definition.

Weckend, M McCullough, K Duffield, C

Bayes, S Davison, C

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Birth, 2024
Issue Date:: 2024-05-27

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Field	Value	Language
dc.contributor.author	Weckend, M
dc.contributor.author	McCullough, K
dc.contributor.author	Duffield, C https://orcid.org/0000-0001-6534-8743
dc.contributor.author	Bayes, S
dc.contributor.author	Davison, C
dc.date.accessioned	2024-12-16T05:01:45Z
dc.date.available	2024-05-02
dc.date.available	2024-12-16T05:01:45Z
dc.date.issued	2024-05-27
dc.identifier.citation	Birth, 2024
dc.identifier.issn	0730-7659
dc.identifier.issn	1523-536X
dc.identifier.uri	http://hdl.handle.net/10453/182582
dc.description.abstract	BACKGROUND: Diagnoses of labor dystocia, and subsequent labor augmentation, make one of the biggest contributions to childbirth medicalization, which remains a key challenge in contemporary maternity care. However, labor dystocia is poorly defined, and the antithetical concept of physiological plateaus remains insufficiently explored. AIM: To generate a definition of physiological plateaus as a basis for further research. METHODS: This qualitative study applied grounded theory methods and comprised interviews with 20 midwives across Australia, conducted between September 2020 and February 2022. Data were coded in a three-phase approach, starting with inductive line-by-line coding, which generated themes and subthemes, and finally, through axial coding. RESULTS: Physiological plateaus represent a temporary slowing of one or multiple labor processes and appear to be common during childbirth. They are reported throughout the entire continuum of labor, typically lasting between a few minutes to several hours. Their etiology/function appears to be a self-regulatory mechanism of the mother-infant dyad. Physiological plateaus typically self-resolve and are followed by a self-resumption of labor. Women with physiological plateaus during labor appear to experience positive birth outcomes. DISCUSSION: Despite appearing to be common, physiological plateaus are insufficiently recognized in contemporary childbirth discourse. Consequently, there seems to be a significant risk of misinterpretation of physiological plateaus as labor dystocia. While findings are limited by the qualitative design and require validation through further quantitative research, the proposed novel definition provides an important starting point for further investigation. CONCLUSION: A better understanding of physiological plateaus holds the potential for a de-medicalization of childbirth through preventing unjustified labor augmentation.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	Birth
dc.relation.isbasedon	10.1111/birt.12843
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.classification	3213 Paediatrics
dc.subject.classification	4204 Midwifery
dc.subject.classification	4205 Nursing
dc.title	Physiological plateaus during normal labor and birth: A novel definition.
dc.type	Journal Article
utslib.location.activity	United States
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/School of Nursing and Midwifery
utslib.copyright.status	open_access	*
dc.date.updated	2024-12-16T05:01:44Z
pubs.publication-status	Published online

Abstract:

BACKGROUND: Diagnoses of labor dystocia, and subsequent labor augmentation, make one of the biggest contributions to childbirth medicalization, which remains a key challenge in contemporary maternity care. However, labor dystocia is poorly defined, and the antithetical concept of physiological plateaus remains insufficiently explored. AIM: To generate a definition of physiological plateaus as a basis for further research. METHODS: This qualitative study applied grounded theory methods and comprised interviews with 20 midwives across Australia, conducted between September 2020 and February 2022. Data were coded in a three-phase approach, starting with inductive line-by-line coding, which generated themes and subthemes, and finally, through axial coding. RESULTS: Physiological plateaus represent a temporary slowing of one or multiple labor processes and appear to be common during childbirth. They are reported throughout the entire continuum of labor, typically lasting between a few minutes to several hours. Their etiology/function appears to be a self-regulatory mechanism of the mother-infant dyad. Physiological plateaus typically self-resolve and are followed by a self-resumption of labor. Women with physiological plateaus during labor appear to experience positive birth outcomes. DISCUSSION: Despite appearing to be common, physiological plateaus are insufficiently recognized in contemporary childbirth discourse. Consequently, there seems to be a significant risk of misinterpretation of physiological plateaus as labor dystocia. While findings are limited by the qualitative design and require validation through further quantitative research, the proposed novel definition provides an important starting point for further investigation. CONCLUSION: A better understanding of physiological plateaus holds the potential for a de-medicalization of childbirth through preventing unjustified labor augmentation.

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http://hdl.handle.net/10453/182582