Exploring early labour care in the context of an institutional reorganisation towards a more women-centred approach: An ethnographic field study

Abstract

Background

Internationally, midwifery is working to improve early labour care by shifting away from delayed admission (i.e., waiting for measurable signs of impending active labour) towards an emphasis on the needs of individual women and their partners. Individualised in-hospital early labour care is a new field that is largely unexplored.

Aim

To explore how midwives provide care for women in early labour within a clinical practice that is transitioning towards a more woman-centred approach.

Methods

The researchers conducted an ethnographic field study using participant observation and informal interviews at a new section for women in early labour alongside the labour ward. The section featured latent-phase rooms for women and their partners who felt uncomfortable staying at or returning home.

Findings

Data analysis identified three main themes: “Navigating Uncharted Terrain” unfolds how embedded care practices challenged detecting women's needs and delivering woman-centred care. “Addressing Insufficient Language for Undefined Needs and Relational Care” highlights the challenges in attending to women's needs due to a lack of specific language for certain care types. Finally, “Caring Within an Institution” emphasises the influence of institutional conditions on achieving woman-centred early labour care.

Conclusion

Despite working in a hospital setting that promotes individualised early labour care, the midwives in our study had limited early labour care experience and needed additional support from the institution in developing new care practices. A woman-centred early labour care program valuing the significance of relational care is necessary to successfully build and implement woman-centred early labour care competencies and practices.