Résumé :
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Aims and objective: The aim of this study was to explore midwives’ experiences and perspectives of current approaches to midwifery care for women with pre-labour or early labour spontaneous rupture of membranes (SROM), with a focus on the potential use of reagent pads by women with SROM. Design: A qualitative methodology using five digitally recorded focus groups. Setting: Two NHS trusts based in the East Midlands and Yorkshire regions of England. Ethics: Ethical approvals were obtained from the Health Research Authority (HRA) and Health and Care Research Wales (HCRW) and the trusts’ research and development departments before commencing the study (project ID 254352). Participants: The purposive sample included 22 community- or hospital-based midwives. Findings: Three overarching themes emerged from the thematic analysis: 1) current SROM management; 2) midwives’ knowledge of reagent pads and information requirements; 3) incorporation of reagent pads in practice. Midwives perceived potential advantages to the use of reagent pads, for example, in the avoidance of increased medicalisation. However, they also identified information needs in relation to the evidence underlying the development of the pads. Our preliminary exploration of midwives’ perspectives identified a range of views, even among midwives working in the same location, and the significant influence of guidelines on practice and practice change. Key conclusions and implications for practice: Midwives require access to information about reagent pads to enable them to provide optimal care to women who may be considering their use. Further research is needed to explore different approaches to incorporation of reagent pads into practice, from feasibility to larger trials of clinical outcomes and cost-effectiveness, accompanied by qualitative exploration of women’s and midwives’ experiences.
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