Use this URL to cite or link to this record in EThOS: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499833
Title: Intrapartum fetal monitoring for woman at low obstetric risk : enabling evidence based midwifery practice
Author: Hindley, Carol
ISNI:       0000 0001 2414 7398
Awarding Body: University of Manchester
Current Institution: University of Manchester
Date of Award: 2009
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Abstract:
Despite its ancient origins, midwifery in the United Kingdom was only accorded professional status in 1902 with the evidence base for midwifery practice emerging in the last twenty-five years (Cluett al, 2006). Contemporary midwifery practice is characterised by a technological model of birth, based predominantly in hospital (Stewart, 2004). An area of technology that is used routinely is: intrapartum electronic fetal monitoring (EFM); a practice derived largely from observational studies conducted by obstetricians. Despite evidence to its limitations, midwives utilise EFM regardless of the woman's risk status (Banta et ai 2002, Alfirevic et al, 2007). Such routine practices are contrary to the National Health Service's commitment to evidence based care (Rosen, 2000) thus, midwives' continued use of EFM merits investigation. The inextricably linked themes in this thesis are those of: evidence-based practice, informed choice and women's/midwives' decision-making. This includes a discussion on the factors that influence midwives' attitudes towards their clinical decisions when using EFM. The views of pregnant women as consumers are explored both in terms of the information women seek and their decision-making preferences for intrapartum monitoring methods. Thus, there is an attempt to improve clinical effectiveness in order that women make informed decisions and that practice is evidence-based. Midwives and managers of maternity services also require evidence-based information to help improve service outcomes. Five papers are presented. Paper one, is a review of the literature at a time when there were no nationally available guidelines on intrapartum monitoring. Papers Two and Three report on the issues raised from interviews with midwives that had a direct influence on their ability to implement evidence based practice. Paper Four reports the views of pregnant women, thus enabling the adaptation of clinical practice where required. Paper Five reports on defensive-practice and its implications for quality/safety issues in maternity care.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.499833  DOI: Not available
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