Dear All,
sorry for my delayed contribution to that fascinating discussion.
Dynamics during labour is one of the most interesting issues during
intrapartum care
in clinical practice as well as in research. We sometimes tend to
forget that comparing
observed with expected frequencies (this is how I understand Odds
Ratio's) is a rather
static approach to analyse interventions during labour. The dynamic
modelling of
labour started only recently as software is now available for this
type
of analysis. In
this respect, the pioneering work of Friedman is appreciated as he
already mentioned
the Gompertz-Makeham approach in modelling dynamics during
labour.
I find it rather challenging to ask how effective care can take place
not only regarding
the outcome of birth but also during intrapartum care itself (e.g.
first
stage). Billie's
comments were very instructive in this respect.
Here is a selection of our work:
Original articles
Gross MM Schwarz CH Burian RA Keirse MJNC Hecker H. Midwifery
teams differ in
their attitudes regarding study participation. Birth Issues (In
press).
Gross MM Hecker H Matterne A Guenter HH Keirse MJNC. Does the
way that women
experience the onset of labour influence the duration of labour?
BJOG 2006; 113:
289-294
Gross MM Hecker H Keirse MJNC. An evaluation of pain and
"fitness" during labor
and its acceptability to women. Birth 2005; 32: 122-128
Gross MM Drobnic S Keirse MJNC. Influence of fixed and time-
dependent factors on
the duration of normal first stage labor. Birth 2005; 32: 27-33
Gross MM Haunschild T Stoexen T Methner V Guenter HH.
Women's recognition of
spontaneous onset of term labor. Birth 2003; 30: 267-271
Burian RA, Froemke C, Hecker H, Schwarz CH, Schippert C, Gross
MM. Onset of
labour: Women's views and midwives' assessment in relation to
first
stage duration
(submitted)
Ayerle GA, Hecker H, Gross MM. Dynamics of labor and birth:
Variables, methods of
analysis, and descriptive results (In preparation)
Reviews
Gross MM. Die Geburtserfahrung * eine Übersichtsarbeit (A Review
of birth
experience). Zeitschrift für Geburtshilfe und Frauenheilkunde 2003;
63: 321-325
Gross MM Antes G. Wissenschaftliche Evidenz aus systematischen
Übersichtsarbeiten zum Gebären (Scientific evidence of systematic
reviews on labour
duration). Zeitschrift für Geburtshilfe und Neonatologie 2003; 207:
17-23
Gross MM Keirse MJNC. Die Klinik des Geburtsbeginns in der
geburtshilflichen
Forschung (The clinical onset of labour in obstetric research).
Zeitschrift für ärztliche
Fortbildung und Qualitätssicherung 2002; 96: 665-670
Gross MM. Rosen für Archie Cochrane. Editorial (Roses for Archie
Cochrane.
Editorial). Zeitschrift für ärztliche Fortbildung und
Qualitätssicherung
2002; 96: 635-
636
Gross MM. Die fünf Geburtszeiten (The five stages of labour).
Zeitschrift für
Geburtshilfe und Neonatologie 2002; 206: 236-241
Book
Gross MM 2001 Gebären als Prozess. Empirische Befunde für eine
wissenschaftliche
Neuorientierung. Bern: Hans Huber Verlag (Birthing as a process-
Evidence for a new
approach in research. Berne: Hans Huber Publishing House)
Kind regards,
Mechthild
Dr. Mechthild M. Gross, RM RN Research Fellow
Department of Obstetrics, Gynecoloy & Reproductive Medicine
Midwifery Research Unit
Medical School Hanover
Carl-Neuberg-Str. 1
D - 30625 Hannover
Tel: ++49 511 532 6116, Fax: ++49 511 532 6851
[log in to unmask]
www.mh-hannover.de/Hebammenforschung.html
Am 15 Feb 2007 um 13:42 hat Chris McCourt geschrieben:
> good points Billie
>
> there is also the issue of what or how professionals choose to
measure
> and record and why
>
> Mary Stewarts's doctoral work highlighted, and we noticed the same
> phenomenon (and commented on it briefly in an article) that midwives
> tend to manipulate records in response to various agenda. Delaying
> recording their assessments or amending the observations they re
cord
> can, they feel, give them and the woman more time in which to allow
> labour to progress. This needs to be taken into account by anyone
> researching labour duration using casenote audit.
>
> If anyone is interested in this further, our article was:
>
> Beake S, McCourt C, Page L. The use of clinical audit in evaluating
> maternity services reform: a critical reflection. Journal of
Evaluation
> in Clinical Practice 1998.
>
>
> can't remember Mary's title now, but maybe she'll respond!
>
> Chris
>
>
>
>
> -----Original Message-----
> From: A forum for discussion on midwifery and reproductive
health
> research. on behalf of Hunter, Billie
> Sent: Wed 14-Feb-07 5:34 PM
> To: [log in to unmask]
> Cc:
> Subject: Re: length of labour
>
> Hi Chris and other interested list members
>
> I've been following this discussion with interest. It seems that
another
> relevant issue is likely to be how labour duration is measured, in
> particular what the start point is considered to be ( the end point
> being fairly clear!) This may be something that has shifted over
time.
> For example, there are new developments which aim to differentiate
> between 'active' and 'latent' phases of labour (the All Wales
Clinical
> Pathway for Normal Labour that I have recently been researching is
one
> of these). If labour is not considered to have started until a woman
is
> in active labour ( as defined by her attendants), this will clearly
> impact on the length of labour that is officially recorded (though
this
> may not necessarily reflect the length of labour as experienced by
the
> woman herself!) This issue could be compounded in units where women
are
> encouraged to stay at home until they are in established (active)
> labour, so that the experiences of the woman prior to admission
become
> invisible. This would seem to have all sorts of implications for
labour
> duration norms - and also for the experiences of women. (I am also
> interested in how it may affect the work of midwives - so that only
> caring women in active labour is seen as 'real work')
>
> Billie
>
> Billie Hunter
> Professor of Midwifery
> Centre for Midwifery and Gender Studies
> School of Health Science
> Floor 2, Vivian Tower
> University of Wales Swansea
> Swansea SA2 8PP
> 01792 518584
> email: [log in to unmask]
>
>
> -----Original Message-----
> From: A forum for discussion on midwifery and reproductive health
> research. [mailto:[log in to unmask]] On Behalf Of
Chris
> McCourt
>
> Sent: 12 February 2007 17:05
> To: [log in to unmask]
> Subject: length of labour
>
>
> dear all
>
> I'm interested to know whether there is any written or research
evidence
> on whether norms of the length of labour have changed in the recent
> past. I'm aware of the impact of Friedmans work on practices in
labour
> wards, but am wondering whether there is anything to suggest further
> trends in what is seen as a 'normal' length of labour (and by
> association, whether this could be related, in either direction, to
> rising intervention rates)
>
> all ideas on relevant evidence sources, or personal/professional
> observations welcome
>
> Chris
--- Ende der weitergeleiteten Nachricht / End of forwarded message -
--
Dr. Mechthild M. Gross, RM RN Research Fellow
Department of Obstetrics, Gynecoloy & Reproductive Medicine
Medical School Hanover
Carl-Neuberg-Str. 1
D - 30625 Hannover
Tel: ++49 511 532 6116, Fax: ++49 511 532 6851
[log in to unmask]
--- Ende der weitergeleiteten Nachricht / End of forwarded message -
--
Dr. Mechthild M. Gross, RM RN Research Fellow
Department of Obstetrics, Gynecoloy & Reproductive Medicine
Medical School Hanover
Carl-Neuberg-Str. 1
D - 30625 Hannover
Tel: ++49 511 532 6116, Fax: ++49 511 532 6851
[log in to unmask]
|
