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Informed consent to midwifery practices and interventions during the second stage of labor -An observational study within the Oneplus trial

Häggsgård, Cecilia LU ; Rubertsson, Christine LU ; Teleman, Pia LU and Edqvist, Malin LU orcid (2024) In PLoS ONE 19(6 June).
Abstract

Objectives To study informed consent to midwifery practices and interventions during the second stage of labor and to investigate the association between informed consent and experiences of these practices and interventions and women's experiences of the second stage of labor. Methods This study uses an observational design with data from a follow-up questionnaire sent to women one month after giving birth spontaneously in the Oneplus trial, a study aimed at evaluating collegial midwifery assistance to reduce severe perineal trauma. The trial was conducted between 2018-2020 at five Swedish maternity wards and trial registered at clinicaltrials. gov, no NCT03770962. The follow-up questionnaire contained questions about experiences of the... (More)

Objectives To study informed consent to midwifery practices and interventions during the second stage of labor and to investigate the association between informed consent and experiences of these practices and interventions and women's experiences of the second stage of labor. Methods This study uses an observational design with data from a follow-up questionnaire sent to women one month after giving birth spontaneously in the Oneplus trial, a study aimed at evaluating collegial midwifery assistance to reduce severe perineal trauma. The trial was conducted between 2018-2020 at five Swedish maternity wards and trial registered at clinicaltrials. gov, no NCT03770962. The follow-up questionnaire contained questions about experiences of the second stage of labor, practices and interventions used and whether the women had provided informed consent. Evaluated practices and interventions were the use of warm compresses held at the perineum, manual perineal protection, vaginal examinations, perineal massage, levator pressure, intermittent catheterization of the bladder, fundal pressure, and episiotomy. Associations between informed consent and women's experiences were assessed by univariate and multivariable logistic regression. Findings Of the 3049 women participating in the trial, 2849 consented to receive the questionnaire. Informed consent was reported by less than one in five women and was associated with feelings of being safe, strong, and in control. Informed consent was further associated with more positive experiences of clinical practices and interventions, and with less discomfort and pain from interventions involving physical penetration of the genital area. Conclusion The findings indicate that informed consent during the second stage is associated with feelings of safety and of being in control. With less than one in five women reporting informed consent to all practices and interventions performed by midwives, the results emphasize the need for further action to enhance midwives' knowledge and motivation in obtaining informed consent prior to performance of interventions.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
19
issue
6 June
article number
e0304418
publisher
Public Library of Science (PLoS)
external identifiers
  • scopus:85195801803
  • pmid:38865296
ISSN
1932-6203
DOI
10.1371/journal.pone.0304418
language
English
LU publication?
yes
id
35bd0de2-23e8-40a9-a305-5a341080eecb
date added to LUP
2024-08-20 13:07:03
date last changed
2024-09-17 16:53:54
@article{35bd0de2-23e8-40a9-a305-5a341080eecb,
  abstract     = {{<p>Objectives To study informed consent to midwifery practices and interventions during the second stage of labor and to investigate the association between informed consent and experiences of these practices and interventions and women's experiences of the second stage of labor. Methods This study uses an observational design with data from a follow-up questionnaire sent to women one month after giving birth spontaneously in the Oneplus trial, a study aimed at evaluating collegial midwifery assistance to reduce severe perineal trauma. The trial was conducted between 2018-2020 at five Swedish maternity wards and trial registered at clinicaltrials. gov, no NCT03770962. The follow-up questionnaire contained questions about experiences of the second stage of labor, practices and interventions used and whether the women had provided informed consent. Evaluated practices and interventions were the use of warm compresses held at the perineum, manual perineal protection, vaginal examinations, perineal massage, levator pressure, intermittent catheterization of the bladder, fundal pressure, and episiotomy. Associations between informed consent and women's experiences were assessed by univariate and multivariable logistic regression. Findings Of the 3049 women participating in the trial, 2849 consented to receive the questionnaire. Informed consent was reported by less than one in five women and was associated with feelings of being safe, strong, and in control. Informed consent was further associated with more positive experiences of clinical practices and interventions, and with less discomfort and pain from interventions involving physical penetration of the genital area. Conclusion The findings indicate that informed consent during the second stage is associated with feelings of safety and of being in control. With less than one in five women reporting informed consent to all practices and interventions performed by midwives, the results emphasize the need for further action to enhance midwives' knowledge and motivation in obtaining informed consent prior to performance of interventions.</p>}},
  author       = {{Häggsgård, Cecilia and Rubertsson, Christine and Teleman, Pia and Edqvist, Malin}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{6 June}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Informed consent to midwifery practices and interventions during the second stage of labor -An observational study within the Oneplus trial}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0304418}},
  doi          = {{10.1371/journal.pone.0304418}},
  volume       = {{19}},
  year         = {{2024}},
}