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Professional Guideline Discrepancies as a Barrier to Labor Progress and Teamwork
Emily A Donelan1, Alexandra Morgan, Jessica Densmore
1Department of Obstetrics and Gynecology and the Department of Medicine, Dartmouth Hitchcock Medical Center, and the Value Institute Learning Center, Dartmouth Health, Lebanon, and the Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire.
Obstetrics and Gynecology
|December 11, 2025
Summary
Discrepancies in national labor management guidelines hinder teamwork. Reconciling these guidelines is crucial for improving interprofessional communication and ensuring collaborative patient care in obstetrics.
Area of Science:
- Obstetrics and Gynecology
- Healthcare Management
- Patient Safety
Background:
- Interprofessional communication and cohesion in labor management are suboptimal in modern obstetrics.
- Discrepancies between national guidelines from the American College of Obstetricians & Gynecologists and the Association of Women's Health, Obstetric and Neonatal Nurses contribute to teamwork breakdown.
Purpose of the Study:
- To identify areas of agreement and disagreement in published guidelines from key professional organizations.
- To propose a national program for guideline reconciliation to improve interprofessional collaboration during labor.
Main Methods:
- Comparative analysis of published documents from the American College of Obstetricians & Gynecologists and the Association of Women's Health, Obstetric and Neonatal Nurses.
- Identification of conflicting recommendations impacting bedside teamwork.
Main Results:
- Significant discrepancies exist between professional organizations' guidelines, leading to conflict and communication "dystocia" on labor units.
- Areas of agreement and disagreement were identified, highlighting specific points of contention.
Conclusions:
- Reconciliation of national labor management guidelines is essential for restoring trust and fostering collaborative patient care.
- A national program focused on evidence-based common ground can bridge existing gaps and enhance teamwork in obstetrics.
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