title: Midwives' beliefs and concerns about telephone conversations with women in early labour.
abstract: OBJECTIVE
  to explore midwives' concerns, experiences and perceptions of the purpose of telephone contacts with women in early labour.
  
  
  METHODS
  a qualitative design based on interpretive phenomenology.
  
  
  METHODS
  two Maternity Units in the Midlands of England.
  
  
  METHODS
  three focus groups of labour ward midwife coordinators and labour ward midwives and nine in-depth interviews of midwives, obstetricians and labour ward receptionists.
  
  
  RESULTS
  the principal finding was that midwives are trying to reconcile gatekeeping of labour wards with individual support for women and these two aspects are often in conflict. Women experiencing prolonged or painful early labour often expect to be admitted to labour wards whereas midwives operate from a belief that women should only be accepted onto labour ward in active labour. They hold this view because labour wards are busy places and being admitted early contributes to unnecessary medical intervention.
  
  
  CONCLUSIONS
  because midwives are trying to reconcile the two conflicting priorities of responding to women's needs and protecting the labour ward from inappropriate admissions, the potential always exists for women's needs to be 'not heard' or marginalised.
  
  
  CONCLUSIONS
  the primary recommendation is that early labour telephone triage should be a discrete service, staffed by midwives who have been trained for this service, working independently of labour ward workloads.
authors: The University of Nottingham, Academic Division of Midwifery, School of Health Sciences, Medical School, A Floor, Nottingham, UK. Electronic address: helen.spiby@nottingham.ac.uk.
authors: Helen
authors: H
authors: Spiby
authors: The University of Nottingham, Academic Division of Midwifery, School of Health Sciences, Medical School, A Floor, Nottingham, UK. Electronic address: denis.walsh@nottingham.ac.uk.
authors: Denis
authors: D
authors: Walsh
authors: Mother and Infant Research Unit, Department Health Sciences, University of York, UK. Electronic address: jo.green@york.ac.uk.
authors: Josephine
authors: J
authors: Green
authors: The Rotherham NHS Foundation Trust, UK. Electronic address: anne.crompton@rotgen.nhs.uk.
authors: Anne
authors: A
authors: Crompton
authors: Nottingham University Hospitals NHS Trust, UK. Electronic address: george.bugg@nuh.nhs.uk.
authors: George
authors: G
authors: Bugg
mesh_terms: D003469:Culture; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000523:psychology*; D062528:Medicalization; D008880:Midwifery / Q000193:education; D009721:Nurse Midwives / Q000523:psychology*; D011247:Pregnancy; D064186:Prenatal Education; D036301:Qualitative Research; D013689:Telephone / Q000706:statistics & numerical data; D014218:Triage / Q000379:methods
keywords: Early labour; Midwives; Qualitative research; Telephone contact