4.6 Editorial Material

A wider agreement is needed on basic intrapartum concepts

Journal

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 228, Issue 5, Pages S994-S996

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2023.02.025

Keywords

active phase; arrested labor; cesarean delivery; childbirth; instrumental vaginal delivery; labor admission; labor and delivery; partogram; second stage

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Healthcare professionals in labor wards worldwide face the challenges of managing an emotionally charged period for women, along with long working hours, sleep deprivation, press scrutiny, and legal disputes. Disagreements among scientific institutions on intrapartum care hinder consistency in patient counseling and teamwork. Clarifying basic concepts, such as admission criteria and intervention thresholds, is crucial for the ease of healthcare professionals' work. The involvement of international and national organizations is important for widespread dissemination of these concepts.
Healthcare professionals working in labor wards worldwide regularly deal with the pressure of managing an emotionally charged and life-changing period for women, their families, and their friends. Furthermore, they frequently deal with long working hours, sleep deprivation, occasional scrutiny from the press, and legal dispute. The existing disagreements among leading scientific institutions on basic concepts of intrapartum care hinder the creation of a collective mental model in the labor ward, an aspect that is required for consistency in patient counseling and effective teamwork. Some of these disagreements are as follows: 1. When should laboring women be admitted to the hospital? 2. How long is the absence of labor progress acceptable before an intervention is proposed? 3. How long should women be allowed to push during the second stage of labor before an intervention is proposed? The international scientific community owes it to the vast number of healthcare professionals working in labor wards worldwide to agree on and provide clear definitions of these basic intrapartum concepts, thus making their work a little easier. International institutions, such as the International Federation of Gynecology and Obstetrics and the World Health Organization, have the highest authority to produce guidelines for the whole world, but the participation of leading national organizations, whose influence reaches well beyond the borders of their countries, is important for the wide dissemination of concepts.

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