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The Use of Video Calls in Early Labor Care: Exploring Midwives’ Views of the Potential Benefits and Challenges
Author(s) -
Kennedy Holly Powell,
Faucher Mary Ann,
Roberts Julie,
Divall Bernie,
Spiby Helen
Publication year - 2018
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/jmwh.12913
Subject(s) - thematic analysis , confidentiality , phone , context (archaeology) , nursing , qualitative research , focus group , psychology , qualitative property , medicine , medical education , business , political science , sociology , marketing , paleontology , social science , linguistics , philosophy , machine learning , computer science , law , biology
This qualitative research study explored the research question of whether midwives in the United States and the United Kingdom see potential benefits and challenges of using video‐calling technology to assess and support women in early labor. Early labor calls to maternity units are a locus of dissatisfaction for childbearing women. Although staying at home has benefits for women, some feel uncared for or unwelcome when they are asked to delay traveling to the maternity unit and may struggle to manage their pain at home. Midwives must build rapport and make accurate assessments over the telephone, without the visual and non‐verbal cues they would use in face‐to‐face care. Admission to maternity units prior to establishment of active labor can lead to increased intervention and higher cesarean rates. Thus, it is important to identify innovative strategies to support women in early labor at home. Methods Qualitative data were gathered through audio‐recorded focus group and individual interviews in 3 UK sites (n = 21) and 2 US sites (n = 32). Data were managed with Atlas.ti qualitative software and thematic content analysis was conducted. Results Preliminary analysis shows that most of the midwives see potential benefits of a video‐calling service, including enhanced assessment capacity through visual cues and increased reassurance for women and their partners. However, some midwives had significant concerns about introducing video calls into early labor care, including doubts about the reliability of the technology and discordant phone types. Within the health care context, legal issues, confidentiality, privacy concerns, and appearing professional, empathic, and focused during video calls were raised. Discussion between midwives about which women had internet access raised concerns about equity. There were variations across types of practices and birth settings that reflected continuity of care and type of call coverage for labor that create challenges to integrating the technology within practices. In some settings, implementation would require consideration of documentation, dedicated call lines, and the development of new policies. Discussion Findings from the completed analysis will be discussed in the context of US and UK maternity care settings, drawing on evidence from the use of video calling in other specialties.