Nurses' views of factors that help and hinder their intrapartum care

To explore labor and delivery nurses' views of intrapartum care, particularly factors that help or hinder their efforts to provide professional labor support.

Content analysis of narrative comments that nurses wrote on questionnaires during a two-part research study on professional labor support in 2001.

Intrapartum registered nurses.

Six themes emerged under the category of factors that hinder nurses' intrapartum care: (a) hastening, controlling, and mechanizing birth; (b) facility culture and resources; (c) mothers' knowledge, language, and medical status; (d) outdated practices; (e) conflict; and (f) professional/ethical decline. Under the category of factors that help nurses' intrapartum care, four themes emerged: (a) teamwork and collaboration, (b) philosophy of birth as a natural process, (c) facility culture and resources, and (d) nursing impact, experience, and autonomy.

Nurses conveyed a spectrum of feelings from intense pride and pleasure to disillusionment, dissatisfaction, and distress based on barriers and facilitators to their ability to provide effective optimal care. They felt strongly that medical interventions often hindered their care and prevented them from providing labor support. Nurses offered blunt, often scathing criticism and also glowing praise for their colleagues in nursing, nurse-midwifery, and medicine regarding the quality of their care.