Primary midwives' experiences of collegial midwifery assistance during the active second stage of labor: Data from the Oneplus trial

• Published in: Birth (Berkeley, Calif.) Vol. 50; no. 4; pp. 868 - 876
• Main Authors: Tern, Helena, Edqvist, Malin, Ekelin, Maria, Dahlen, Hannah G., Rubertsson, Christine
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-12-2023
• Subjects: Childbirth & labor; Clinical trials; collegial assistance; Health Sciences; Hälsovetenskap; Intervention; Medical and Health Sciences; Medicin och hälsovetenskap; Midwifery; Midwives; Nursing; Omvårdnad; Perineal trauma; severe perineal trauma; Work experience; collegial assistance; intervention; midwifery; severe perineal trauma; work experience
• ISSN: 0730-7659; 1523-536X; 1523-536X
• DOI: 10.1111/birt.12739

Background
Collegial midwifery assistance during the active second stage of labor that involves a second midwife being present has been shown to reduce severe perineal trauma (SPT) by 30%. The aim of this study was to investigate primary midwives' experiences of collegial midwifery assistance with the purpose of preventing SPT during the active second stage of labor.
Methods
This study uses an observational design with data from a multicenter randomized controlled trial (Oneplus). Data consist of clinical registration forms completed by the midwives after birth. Descriptive statistics as well as univariable and multivariable logistic regression were used to analyze the data.
Results
The majority of the primary midwives felt confident (61%) and were positive (56%) toward the practice. Midwives with less than 2 years' work experience were more likely to completely agree they felt confident (aOR 9.18, 95% CI: 6.28–13.41) and experience the intervention as positive (aOR 4.04, 95% CI: 2.83–5.78) than those with over 20 years' work experience. Factors such as duration of time spent in the birthing room by the second midwife, opportunity for planning and if the second midwife provided support were further associated with the primary midwife's experience of the practice as being positive.
Conclusions
Our findings indicate that having a second midwife present during the active second stage of labor was an accepted practice, with the majority of primary midwives feeling confident and positive toward the intervention. This was especially pronounced among midwives with less than 2 years' work experience.