Learning Objective 1: ...contrast the merits of directed and non-directed pushing during the second stage of labor as related to maternal and fetal well-being.
Learning Objective 2: identify the specific barriers to implementation of non-directed pushing as reported by labor and delivery nurses.
A qualitative descriptive method was utilized involving six focus groups with 36 participants. The particpants were recruited from major metropolitan areas in the north-east and the southern United States through AWHONN.
The participants reported several barriers to utilization of non-directed pushing. Every participant in each of the seven focus groups identified the concept of individual as a barrier. The participants further categorized the concept of the individual into categories. Three categories emerged from the data related to the concept of the individual: physician, nurse, and the patient/family unit. Subcategories were found in the data relating to each of the main categories. These subcategories were identified across all seven of the focus groups and included: control, change, education, time, and noise.
Understanding the specific nurse-reported barriers to implementation of non-directed pushing will provide opportunities to facilitate a nursing practice change. The barriers show the importance of managing change, providing education, team-building, addressing issues related to time, and negotiating unit culture.
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