Irish and New Zealand midwives' expertise in expectant management of the third stage of labour: the 'MEET' study.
OBJECTIVE
to explore the views of expert midwives in Ireland and New Zealand of the skills they employ in expectant management of the third stage of labour (EMTSL).


METHODS
university ethical approval was granted for a qualitative descriptive study in 2010. Recorded, semi-structured interviews were undertaken. Constant comparative analysis was used.


METHODS
community birth settings in Ireland and New Zealand.


METHODS
27 consenting midwives who used EMTSL in at least 30% of births, with PPH rates less than 4%.


RESULTS
the majority of respondents believed the third stage was a special time of parent-baby discovery and 'watchful waiting', with no intervention necessary. Great importance was placed on women's feelings, behaviour and a calm environment. Skin-to-skin contact, breast feeding, not clamping the cord, upright positions and maternal effort, sometimes assisted by gentle cord-traction were also used.


CONCLUSIONS
some components of EMTSL identified by these expert midwives are not recorded in text-books, but are based on experience and expertise. These elements of EMTSL add to midwifery knowledge and provide a basis for further discussion on how normal physiology can be supported during the third stage.


CONCLUSIONS
use of these elements is recommended for women who request EMTSL, and for those in countries without ready access to uterotonics.
School of Nursing and Midwifery, Trinity College Dublin, 24, D'Olier St, Dublin 2, Ireland. cbegley@tcd.ie
Cecily M
CM
Begley
Karen
K
Guilliland
Lesley
L
Dixon
Mary
M
Reilly
Caroline
C
Keegan
D000328:Adult; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007494:Ireland; D007749:Labor Stage, Third; D008880:Midwifery / Q000379:methods*; D009520:New Zealand; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D061214:Patient Safety; D011181:Postnatal Care / Q000379:methods*; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D055815:Young Adult