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How should student midwives best conduct labour room observations in an unobtrusive way?

(17 Posts)
LocalEditorNorfolk Tue 20-Jan-15 14:53:20

Dear all,

Please see below an enquiry Mumsnet has received from a student who is keen to get views from Mumsnetters. Please add any feedback you may have; this will help her plan her research. Many thanks.

I am a midwife undertaking research for a PhD. My Research will take the form of case studies of two midwifery led birth units, looking specifically at midwifery practice. I will be obtaining full clearance from an Ethics Committee and from the Birth Units themselves before I begin the study, and women and midwives will have to give voluntary consent to take part.

I recognise that having a researcher in the birthing room may cause distraction and disturbance so would like to minimise this. I will not be participating in care. I will be observing.

My questions are:

How can I cause as little disruption as possible? Where should I place myself in the birthing room? Would it matter whether I used pen and paper or an electronic tablet to record what I observe? How could I ensure I do not interfere in the relationship between women and midwife?

fattymcfatfat Tue 20-Jan-15 14:58:33

Just be there and be confident that you belong....honestly I am too busy concentrating on the pain and actually giving birth to really give a hoot who is there! But thats just me other mums may feel different.

HearMyRoar Tue 20-Jan-15 15:04:36

As a general rule I would say you just need to stay out the way and keep quiet. I really don't think what you write on matters in the least. I would just avoid asking any questions during labour unless you like being sworn at profusely.

I am assuming that you will be asking the permission of the mother so if she agreed to the principle just ask her what she wants and agree that if she changes her mind you will leave immediately and without question.

Missymum6 Tue 20-Jan-15 15:11:32

We had student midwives in with us, although I had a c section not sure if I'm much help. I'm pretty sure they were part of the materal medicine side (I was asked if they could be present when booking my c section) I had no problem, having had a medical condition for a while I usually get asked if they can sit in in apps ect. I have to say I didn't even notice they were there, they were stood well away from us and thanked us after. I think as long as your not in a intrusive place your be ok. Not sure if I'm any help as I'm sure an actual birth is a lot different.

sbear22 Tue 20-Jan-15 15:54:51

in my opinion, as a paranoid first timer, i would hate someone to be taking notes on an electronic tablet as i'd worry that they were recording or filming or taking photos! pen and paper would be fine cos i wouldn't have that worry (hey, you never know in this technologically advanced age). also i'd say ensure the mother is fully enformed as to what you're writing your notes about otherwise they might feel more uncomfortable. good luck smile

ImperialBlether Tue 20-Jan-15 15:59:07

sbear, that's what I was thinking, that they might be filming or recording the birth. Pen and paper would be more reassuring.

Dogsmom Tue 20-Jan-15 16:05:31

I had student midwives present in my first labour at every stage, they were all lovely and introduced by the qualified midwife who asked if I minded them being present then after each examination they asked if the student could examine too and see what they thought.

I think the main thing is to be confident as it gives reassurance at a scary time, I wouldn't like them to be hovering around the back looking nervous or hardly speaking.
From memory I had 5 separate students throughout the labour and delivery and they were all as confident and professional as the qualified one, they all had times where they were sat with me and if I hadn't been told which was which I wouldn't have known who the student was.

Re pen and paper or tablet it hadn't crossed my mind but I agree that pen and paper seems better, maybe because tablets can do so many other things and I'd have suspicions they were on Facebook or Candy Crush grin, pen and paper seems more professional.

ineedtogetthisout Tue 20-Jan-15 16:17:57

I have had a few births now but won't allow students in anymore.

What I would have liked, but never had was for the student to introduce themself once Id given the ok to the midwife, and a "thank you for allowing me to be here" wouldn't have gone amiss either.

The last two I had were obviously quite young and getting to know the midwives and were either acting a bit ditzy which really put me off or they were more interested in gossiping about their weekends and completely unprofessional.

I'm not sure if it would be relevent to you, but the students didn't read my notes about previous losses I've had and therefore asked upsetting questions, so I would avoid asking anything potentially upsetting without knowing some of the history of the person. Even asking if this is someones first child can be upsetting. If there is any conversation then take your cue from what they say.

I would also say pen and paper would be better.

duckbilled Tue 20-Jan-15 17:31:17

I had a student midwife and it was his very first birth, he was very professional. Stayed in the background but followed all the midwifes instructions and asked some sensible questions. When he was a really big help was holding my hand when I was being stitched and dh was with dd, and taking some pics for us... He was great, although he looked slightly traumatised by the end of a scary and difficult labor blush

LocalEditorNorfolk Wed 21-Jan-15 09:38:00

Thank you very much for all these helpful comments which Mumsnet will pass directly onto this researcher. Please do continue to add to this thread if you have anything more to add. Many thanks.

knittingirl Wed 21-Jan-15 11:48:42

Just sitting quietly to one side in the room - not in the Mum's direct line of sight. Also, when you introduce yourself make it clear that if the Mum changes their mind at any point they just have to say and you will leave immediately.

gincamelbak Wed 21-Jan-15 12:07:04

I had student midwives in when in labour with DD. It was awful tbh. Firstly they hadn't believed that I was in labour (was induced, went into labour on induction ward overnight with irregular contractions water didn't break. They told me I wasn't in labour until I begged them to check. I was 8/9cm dilated.) and once I was in the labour room they pretty much ignored ME but spent a lot of time writing up the notes on the trace on the baby and whatever else they were doing. Nobody spoke to me apart from asking every so often if I was ok. Maybe they said more, I don't know, but if felt like I was there to be observed and recorded, they didn't interact with me.

If you are there to observe the midwives, then I'd suggest staying in the corner with pen and paper quietly. Ask the labouring woman if she wants you to talk with her, if she wants you in the room still. She may be ok with you in there at first but change their mind after a while so really best to check that they are still ok.

The most important thing is the labouring woman and giving birth safely to a live baby. If she gets anxious or uncomfortable with you there then leave as quickly and unobtrusively as possible. If she wants to interact with you, then talk to her. Take you lead from her!

ShootingStar71 Wed 21-Jan-15 12:11:05

I had a student midwife who was coming towards the end of her training at the c section birth of my daughter in October 2014. Totally agree with Duckbilled....She was exceptional, introduced herself to me and my partner, asked if we minded her being present throughout & said she would leave if we felt uncomfortable at any stage. She was absolutely professional throughout whilst at the same time looked after me & held my hand through all the scary bits, & kept me confident throughout. All I can say is that she was a credit to all midwives and absolutely lovely throughout the birth. I believe that she was well briefed on the situation by the qualified midwife prior to be introduced to me and at no time did I feel that she was intrusive & I didn't expect her to stand in the background in fact she probably helped me a lot. Having said that I completely understand if some ladies feel uncomfortable if they have experienced difficulties & unpleasant situations in the past. Good luck with your research & studies.

onthematleavecountdown Wed 21-Jan-15 13:01:15

No tablet or phone, would think you were filming!

Stay quiet, only speak once spoken too.

Have full knowledge of patient history if you can. Like others said. My pregnancy is high risk and the result of years and years of fertility treatment, knowing this would definitely avoid any awkward questions.

Guyropes Fri 23-Jan-15 19:36:54

A researcher, you say, observing? This is very different to a student midwife who is supposed to be learning how to be a midwife and participating in your care. I think a lot of people on this thread have not understood the difference, so it might be a good idea to clarify this with the mother when seeking consent. I also think sitting in a corner out of the way is a good idea: it shows you are not participating in the event.
Also pen and paper definately.

Good luck.

GoooRooo Fri 23-Jan-15 19:45:38

I didn't give a stuff who was in the room when I was in labour. The whole England rugby team could've come in to have a look and I wouldn't care. I was far too focused on getting the baby out to worry about who had seen my foof.

Ellamaclictor Fri 30-Jan-15 13:30:02

Thank you so much for all of your comments. I will take on board your opinions about recording my observations and your concerns about my stopping the research if women withdraw consent, and making this very clear to women. These issues will be made more clear in the Participant Information Sheet that I will be giving to potential participants.
Just to clarify: I am a midwife, not a student midwife, and will not be giving any care or asking any questions of women in relation to their care.

I will have to get consent from both midwives and women before I can observe practice, and either party will be able to withdraw consent at any time. I won't be observing practice in any of the Norfolk/Suffolk birth units.
Once again you input has been very valuable and if you have anything more to say please feel free.

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