title: Management of the third stage of labour--focus group discussions with Swedish midwives.
abstract: OBJECTIVE
  to explore Swedish midwives' experiences of management of third stage of labour.
  
  
  METHODS
  six focus group discussions were performed and the analysis was based on content analysis.
  
  
  METHODS
  the midwives worked at six hospitals: three university hospitals and three provincial hospitals located from the south west to the north of Sweden.
  
  
  METHODS
  32 midwives with extensive experience of assisting women in childbirth.
  
  
  RESULTS
  the analysis generated three categories: 'bring the process under control', 'protect normality and women's birthing experiences' and 'maintain midwives' autonomy'. This study demonstrates that management of the third stage of labour varies greatly. Not all midwives were convinced that administration of prophylactic oxytocin in the third stage of labour was always the best alternative for all women who had a normal birth.
  
  
  CONCLUSIONS
  the midwives exhibited self-confidence in evaluating the physiological process, and endeavoured to leave the physiological process undisturbed if no other risks were apparent. Their decisions concerning third stage management were based on a combination of previous experience, hospital guidelines, risk assessment and sensitivity to each woman's needs. This study demonstrates that management of the third stage of labour varies greatly. The findings show the importance of reaching a balance between treating birth as a normal process and as a biomedical event.
authors.affiliation: Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, 416 78 Göteborg, Sweden. Elisabeth.Jangsten@vgregion.se
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Jangsten
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Hellström
authors.forename: Marie
authors.initials: M
authors.lastname: Berg
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007749:Labor Stage, Third; D008880:Midwifery / Q000379:methods*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D007744:Obstetric Labor Complications / Q000451:nursing* / Q000517:prevention & control; D011247:Pregnancy; D013548:Sweden; D055815:Young Adult