Re: [ozmidwifery] research @ uni

[Mary Murphy]

Jen, What a wonderful research question!  As a homebirth midwife I do not routinely do V.E's to confirm full dialtion before "allowing" a woman to push.  Many primiparous women do not have V.E's at home and progress without harm, to the birth of their babies.  The only time I do a V.E in that situation  is when the women is saying that it "really hurts" when she pushes. That is often a signal and  means that she isn't yet in 2nd stage or that there is a hand lying alongside the head (not proven until birthing). It shouldn't hurt so badly when in  normal 2nd stage. If I suspect a woman is not really in 2nd stge, I ask her to try and breathe through the contractions to the best of her ability until the head descends some more.  Occasionally there is an "anterior lip".   As for "allowing"  What does that mean?  The woman will push when she has to and no amount of "not allowing" will stop her.  Multiparous women at home never have a V.E to 'Prove' full dilation.  Why would you?  Also there is that lovely "red/purple line" that appears.  I think that is a really good guide to full dilation, but I don't always see it.  In the research question, are you going to differentiate between Primips or multips?  I would suggest just using primips.  If it is entrenched behaviour or routine, you might not get the numbers in hospitals so think about involving a homebirth or birthcentre practice.  Also, if you haven't already, do your literature search in homebirth/midwives magazines.  Midwifery today etc.  Love to hear how you are going with it and what you decide.  MM