A survey of Australian midwifery intravenous fluid management during induction of labour

Background

Guidelines are in place for obstetric indications that warrant an induction of labour as detailed by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and Safer Care Victoria. However, no such guidelines or policies exist for the management of fluids during labour.

Aim

To determine if there is variability within Australia, as it pertains to the management of intravenous fluids, during induction of labour, as captured by Australian midwives’ responses to an electronic survey.

Methods

A REDCap survey was made available to midwives registered with the Australian College of Midwives, through the college’s monthly newsletter.

Findings

A total of 189/4445 (4.25%) midwives registered with the Australian College of Midwives completed the survey. A response was received from midwives covering all states and territories of Australia, from a total of 62 hospitals. The primary place of work was listed as a public hospital by 95.2% of the respondents. Variability was noted for the concentration of oxytocin that was used. The crystalloid of choice was either Hartmann's solution (73.5%) or normal saline (25.4%).

Discussion

The management of intravenous fluid as documented by midwives during induction of labour varied widely throughout Australia and even varies within the same institutions. This may suggest that within these institutions, a policy to guide intravenous fluid management does not exist, which may be indicative of the lack of literature to guide such a policy.

Conclusion

It is currently unknown if the wide variability in intravenous fluid management during induction of labour is impacting upon birth outcomes. Further research in this area is warranted.