Midwifery diagnosis of labour onset

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Abstract
The premise of this study was that midwifery diagnostic cues have been subsumed by the biomedical approach. The purpose of this qualitative study was to find out how midwives diagnose labour onset and create a model of that knowledge. Two approaches for data collection were used: A preliminary midwife focus group and a series of in-depth interviews with an expert midwife. The focus group generated themes and concepts leading to a three part conceptual framework: physiological, sociophilosophical and psychological. The main findings were that midwives use a variety of emotional, psychological and physical cues to diagnose labour onset. The overall ‘tendency’ for labour onset is described as ‘increasing inward focus’, reflected in cues such as movements, breathing, conversation and emotional states. The recognition and use of these cues is influenced by the political and social context in which a midwife works. The final model demonstrates how midwives can work with women outside the biomedical paradigm. It is hoped that this research will contribute to a midwifery discourse surrounding labour onset care.

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