Midwives' experiences in the clinical management of oxytocin infusion for labor induction and augmentation: a qualitative study.

BACKGROUND

Midwives play a central role in administering oxytocin for labor induction and augmentation. Understanding their experiences with oxytocin management can provide valuable insights for refining administration protocols and improving clinical outcomes.

METHODS

This exploratory qualitative study, guided by a descriptive phenomenological approach, employed semi-structured interviews to explore midwives' experiences with oxytocin infusion for labor induction and augmentation. Between December 2023 and May 2024, a total of 15 clinical midwives from 10 hospitals in Guangdong Province, China, participated in the study. Data were analyzed using Colaizzi's seven-step method with NVivo 12.0 software.

RESULTS

Three key themes emerged from the analysis: (1) Clinical Alertness versus Systemic Vulnerabilities, (2) Professional Fulfillment versus Loss of Autonomy, and (3) Accumulated Experience versus Lack of Guidelines. These themes underscore critical factors contributing to emotional burden, safety concerns, and teamwork challenges in oxytocin management, and highlight the potential risks to maternal and neonatal safety in clinical practice.

CONCLUSIONS

Missed nursing care is a recurrent issue in the administration of oxytocin for labor induction and augmentation. Despite demonstrating competence in managing oxytocin, midwives face challenges such as limited decision-making authority, ambiguous clinical guidelines, and insufficient standardized training. To address these gaps, healthcare institutions should prioritize the development of clear, evidence-based clinical protocols for oxytocin use and implement regular, standardized training programs to enhance midwives' skills and confidence. Furthermore, empowering midwives with greater decision-making autonomy and promoting effective communication within multidisciplinary teams are essential steps toward improving the quality of care.