RESEARCH PAPER
One-to-one care routines and compliance with the national professional recommendation on continuous intrapartum support in Norway: A national survey
 
More details
Hide details
1
Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
2
Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
3
Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
CORRESPONDING AUTHOR
Aase S. Devold Pay   

Department of Obstetrics and Gynecology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
Publish date: 2019-07-25
Submission date: 2019-03-11
Final revision date: 2019-06-14
Acceptance date: 2019-06-16
 
Eur J Midwifery 2019;3(July):14
KEYWORDS
TOPICS
ABSTRACT
Introduction:
In 2010, the Norwegian Directorate of Health introduced the guideline ‘Safe maternity services – quality standards for maternal care’. These standards include adequate staffing with health care personnel for birth units to ensure responsible monitoring and treatment. Birth units are to follow the professional recommendation that every woman has a midwife present during established labor. This study presents data from birth units on compliance with the national recommendation for one-to-one care during labor.

Methods:
A web-based questionnaire was emailed to chief midwives of all birth units in Norway (n=48) in May 2018. The questionnaire contained a total of nine multiple-choice, scaled-response-format, and free-text questions.

Results:
The questionnaire response rate was 100%. All birth units reported that they offered women one-to-one care during labor to a large extent. Sixty-five per cent of the birth units had procedures to ensure that midwives were present during established labor. Deviations from the recommendation were recorded in one-fourth of birth units. Thirty-eight per cent of respondents reported that staff training had been provided; 56% of birth units stated that the recommendation led to an increased presence of midwives during labor. Financial constraints (35%) and difficulty of compliance (27%) were cited as obstacles to meeting the recommendation for one-to-one care during labor.

Conclusions:
The majority of birth units reported that they follow the recommendation for one-to-one care during established labor, but compliance with this recommendation in practice remains unclear. Areas of improvement relate to routines describing the presence of midwives during labor, registration of deviations, and staff training in one-to-one care.

CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
There was no source of funding for this research.
AUTHORS' CONTRIBUTIONS
All authors planned and initiated the study. A.S.D.P., B.G.B., and M.R. developed the questionnaire. B.G.B. and M.R. collected the data, did the data analyses and wrote the first draft of the paper. A.S.D.P. wrote the second draft of the paper. All authors revised the manuscript.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
REFERENCES (12)
1.
The Norwegian Health Directorate. Et trygt fødetilbud Kvalitetskrav til fødselsomsorgen [Safe maternity services – quality standards for maternity care]. https://www.helsebiblioteket.n.... Published 2010. Accessed March 11, 2019.
 
2.
Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017;7:Cd003766. doi:10.1002/14651858.CD003766.pub6
 
3.
Halldorsdottir S, Karlsdottir SI. The primacy of the good midwife in midwifery services: an evolving theory of professionalism in midwifery. Scand J Caring Sci. 2011;25(4):806-817. doi:10.1111/j.1471-6712.2011.00886.x
 
4.
Howarth AM, Swain NR, Treharne GJ. First-time mothers' perspectives on relationships with and between midwives and doctors: insights from a qualitative study of giving birth in New Zealand. Midwifery. 2012;28(4):489-494. doi:10.1016/j.midw.2011.07.004
 
5.
Neilson JP, Lavender T, Quenby S, Wray S. Obstructed labour. British medical bulletin. 2003;67(1):191-204. doi:10.1093/bmb/ldg018
 
6.
Ministry of Health and Care services. Oppdragsdokument 2017 Helse Sør-Øst RHF [Assignment document 2017 South-Eastern Regional Health Authority]. https://www.regjeringen.no/glo.... Published 2017. Accessed March 11, 2019.
 
7.
The Norwegian Health Directorate. Metoder og verktøy [Methods and tools]. https://helsedirektoratet.no/m.... Published 2016. Accessed March 11, 2019.
 
8.
Johansen LT, Pay ASD, Broen L, Roland B, Oian P. Are stipulated requirements for the quality of maternity care complied with? Tidsskr Nor Laegeforen. 2017;137(17). doi:10.4045/tidsskr.16.1070
 
9.
Eiring Ø, Pedersen MS, Borgen K, Jamtvedt G. Prosedyrearbeid – meningsløst mangfold? [The making of clinical procedures – meaningless diversity?] Oslo, Norway: Nasjonalt kunnskapssenter for helsetjenesten; 2010. https://fhi.brage.unit.no/fhi-.... Accessed March 11, 2019.
 
10.
Tucker J, Parry G, Penney G, Page M, Hundley V. Is midwife workload associated with quality of process of care (continuous electronic fetal monitoring [CEFM]) and neonatal outcome indicators? A prospective study in consultant-led labour wards in Scotland. Paediatr Perinat Epidemiol. 2003;17(4):369-377. doi:10.1046/j.1365-3016.2003.00524.x
 
11.
National Institute for Health and Care Excellence. Safe midwifery staffing for maternity settings. https://www.nice.org.uk/guidan.... Published February, 2015. Accessed March 11, 2019.
 
12.
Ministry of Health and Care services. Forskrift om ledelse og kvalitetsforbedring i helse- og omsorgstjenesten [Retgulations concerning management and qualityimprovement in health care services]. https://www.helsedirektoratet..... Published 2016. Accessed March 11, 2019.
 
eISSN:2585-2906