A study of midwife-medical staff interaction in a labour Ward environment

The quality and quantity of midwife-doctor referrals in an intrapartum setting were assessed by retrospective and prospective recording over 4 weeks. Of the 377 women delivering during the month, 259 (69 per cent) required the attention of a doctor during labour. Of 204 women who had been allocated midwife-led intrapartum care, reflecting a low risk assessment, 90 (44 per cent) required medical assistance, mainly for failure to progress (33 per cent), fetal distress (26 per cent) and analgesia (23 per cent). Levels of satisfaction with resulting consultations, expressed by both midwifery and medical staff were high. In 94 per cent of referrals midwives reported that the medical staff performance was either good or very good and 94 per cent of medical staff reported the referrals as either necessary or very necessary. Subtle trends in the staff responses highlighted possible areas for further improvement, offering guidance for developments of new labour ward policies.