Communication Key to Women's Experiences with Fundal Pressure During Childbirth

Despite longstanding guidelines advising against the routine use of fundal pressure during childbirth, this practice persists in many maternity clinics worldwide. Fundal pressure involves applying deliberate force to the upper part of the uterus to accelerate labor, yet the evidence supporting its effectiveness remains unclear. International guidelines recommend that if such intervention is necessary, it should be performed only with the woman's informed consent and under strict indications.

A recent qualitative study conducted by the University Hospital of Bonn, in collaboration with the University of Bonn and the University Hospital Cologne, sheds light on how women's subjective experiences of fundal pressure are significantly influenced by the communication and care they receive. The study, published in the Archives of Gynecology and Obstetrics, analyzed 12 women’s experiences within the past year. Findings reveal that perceptions of the procedure—whether positive, neutral, or negative—are primarily shaped by how well women understand the reasons for the intervention and how supported they feel.

The researchers found that when obstetric staff provided clear explanations and acknowledged the women’s ability to make informed decisions, women were more likely to perceive the procedure as supportive, even if they experienced discomfort. Conversely, a lack of information or feeling overwhelmed led to negative experiences. The study emphasizes that the manner of communication plays a crucial role in shaping women's childbirth experiences, highlighting that even a controversial intervention like fundal pressure can be experienced positively if properly handled.

The study categorized women’s experiences into three groups: six women reported positive experiences, three neutral, and three negative. Consistently, the level of perceived manageability—how well women could cope with the procedure—correlated with their satisfaction. Key to these perceptions was the ability of healthcare providers to explain the situation effectively and secure the woman’s consent.

The researchers advocate for strict adherence to guidelines emphasizing informed consent and respectful communication during labor interventions. They underscore that the focus should not only be on the procedure itself but equally on how it is communicated and managed, ensuring that women feel respected and informed.

For more details, see the full study: Making sense of fundal pressure: A qualitative study on women's experiences of a non-evidence-based yet commonly practiced intervention.

This research highlights the importance of effective communication in obstetric care, demonstrating that how interventions are presented and explained can significantly influence women’s childbirth experiences and perceptions.