Women's experiences of vaginal examinations in labour

Abstract

Objective: To investigate women's perceptions of their experiences of vaginal examinations in labour.

Design: A prospective, analytic survey design using anonymised, self-completion, postal questionnaires.

Setting: A multi-centre study conducted in 2002 in three midwifery units in Cambridgeshire, England.

Participants: An unselected, consecutive sample of 104 primiparae expected to deliver their first baby in hospital after an uneventful pregnancy at 37 weeks or over, with the fetal head presenting, of whom 73 finally took part; the response rate was 70%.

Findings: On the basis of a 20-item Likert-type scale, a notional satisfaction index score of 74% was calculated. This was based on 1435 items of ordinal data, suggesting an encouraging measure of contentment with the privacy, dignity, sensitivity, support and frequency with which vaginal examinations in labour were managed. However, there was some scope for improvement in areas such as associated pain, opportunities to refuse examinations and more detailed information-giving. No statistically significant differences in women's perceptions could be demonstrated in the three midwifery units in relation to the numbers of vaginal examinations carried out in labour or the women's perceptions of their care by health professionals.

Conclusions: Evidence based on the women's perceptions indicates that 53% of women were more than satisfied with the conduct of their vaginal examinations in labour; a further 44% were satisfied; and the remaining 3% were less than satisfied.