uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Intrapartal care in a Swedish maternity unit after a quality-improvement programme
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Obstetrisk forskning/Axelsson)
2007 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 23, no 2, 113-122 p.Article in journal (Refereed) Published
Abstract [en]


to study the effects of a quality-improvement programme (QIP) on documented intrapartal midwifery care in the context of a conventional maternity unit. The aim of the QIP was to improve intrapartal midwifery care in accordance with the World Health Organization (WHO)'s recommendations for care in normal birth, without decreasing the number of spontaneous vaginal births.


an audit instrument, developed from WHO recommendations for care in normal birth, was used to compare birth records from before and after the implementation of a QIP. Two hundred and twelve consecutive birth records were examined in the pre-test and 240 in the post-test period.


a conventional maternity unit in Western Sweden.


an overall documented improvement towards the recommendations by WHO was observed, especially in items for which guidelines were developed; more women were in active labour, intermittent auscultation increased in first and second stage, and oxytocin augmentation decreased in the first stage. The improved care did not influence the number of spontaneous vaginal deliveries or the duration of active labour and second stage.

Conclusion and implications for practice

a QIP facilitated implementation of WHO's recommendations for care in normal birth. Most of the documented care changed in favour of the WHO recommendations. The findings highlight the importance of professional discussions and use of guidelines to implement changes and to show how midwifery care can change in a conventional ward. However, the findings must be interpreted with some caution because of the sample size and because the findings are based on documented, not observed, care.

Place, publisher, year, edition, pages
2007. Vol. 23, no 2, 113-122 p.
Keyword [en]
Documentation, Implementation, Intrapartal, Quality improvement, WHO
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-11058DOI: 10.1016/j.midw.2006.03.012ISI: 000247185500003PubMedID: 17059859OAI: oai:DiVA.org:uu-11058DiVA: diva2:38826
Available from: 2007-05-16 Created: 2007-05-16 Last updated: 2011-02-05Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMedhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=17059859&dopt=Citation

Search in DiVA

By author/editor
Axelsson, Ove
By organisation
Department of Women's and Children's Health
In the same journal
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 138 hits
ReferencesLink to record
Permanent link

Direct link