What makes labor difficult? Predictors and features of difficult labor in women’s and midwives’ perspective

Abstract Aim. The aim of this study was to identify what are the features of ‘difficult labor’ in the perspective of women giving birth and midwives providing care. Material and methods. Cross-section, preliminary study based on the analysis of the labor observation form and level of labor difficulty assessment form designed for the purpose of this study and fi lled in by the midwives participating in the study. The participants were 31 midwives working on the labor unit in one of the hospitals in Warsaw, Poland and 152 women who gave birth. Results. Women who had epidural, larger babies and a negative attitude towards birth and a prolonged fi rst stage of labor, were more likely to assess their labor as difficult. Among midwives labors with a longer second stage, abnormal uterine contraction patterns, and prolonged latent phase and fi rst stage of labor were assessed as more difficult. Conclusions. Some labors, despite being classified as physiological, require more effort on the part of both the midwife and woman giving birth and end with a higher level of fatigue for both. Predictors of difficult labor should be used by healthcare personnel as a guidance to help identify women at risk of negative labor experiences.