title: Sense and sensibility: Swedish midwives' ambiguity to the use of synthetic oxytocin for labour augmentation.
abstract: The use of intravenous artificial oxytocin for augmentation of labour is very common in midwifery care in Sweden. Studies have shown that oxytocin is often administered to women in labour who have no signs of labour dystocia. It was the aim of this study to examine Swedish midwives' views on and experiences of labour augmentation in the context of normal labour. Individual interviews were carried out with 15 midwives from southern Sweden. The material was analysed using qualitative content analysis, which resulted in one theme: sense and sensibility and four main categories: permissible situations, motivating the decision, intervening in the birth process and iatrogenic awareness. The results showed that midwives expressed ambiguity about augmentation of labour. They were of the opinion that oxytocin was used very often and sometimes unnecessarily. There is awareness that interventions to augment labour can result in undesirable effects on the birth process. Despite this, deeper discussion of this problem was avoided in the interviews. Further research should focus on the process involved when midwives weigh pros and cons when deciding to augment labour. More knowledge is also needed about the barriers for optimal care in labour that are inherent in health-care systems.
authors.affiliation: Department of Health Sciences, Lund University, PO Box 157, S-221 00 Lund, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Ekelin
authors.affiliation: Department of Health Sciences, Lund University, PO Box 157, S-221 00 Lund, Sweden; Department of Obstetrics & Gynaecology, Helsingborg Hospital, S-251 87 Helsingborg, Sweden.
authors.forename: Judith
authors.initials: J
authors.lastname: Svensson
authors.affiliation: Department of Health Sciences, Lund University, PO Box 157, S-221 00 Lund, Sweden; Department of Obstetrics & Gynaecology, Skåne University Hospital, SE-205 02 Malmö, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Evehammar
authors.affiliation: Department of Health Sciences, Lund University, PO Box 157, S-221 00 Lund, Sweden; Department of Obstetrics & Gynaecology, Helsingborg Hospital, S-251 87 Helsingborg, Sweden. Electronic address: linda.kvist@med.lu.se.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Kvist
mesh_terms: D004420:Dystocia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000451:nursing*; D008880:Midwifery / Q000379:methods* / Q000592:standards; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D010121:Oxytocin / Q000627:therapeutic use*; D011247:Pregnancy; D036301:Qualitative Research; D013548:Sweden
chemical_list: D010121:Oxytocin
keywords: Augmentation; Midwife; Normal labour; Oxytocin