Obstetrics by ear. Maternal and caregiver perceptions of the meaning of maternal sounds during second stage labor.

In a study at the University of Colorado School of Nursing, Department of Nurse-Midwifery, women's second stage labors were videotaped to study caregiver behavior during second stage labor. Postpartum interviews of the mothers (n = 10) and caregivers (n = 16) were conducted to learn about their responses as they viewed the videotapes. Qualitative analysis was conducted of the transcribed interviews using the Ethnograph computer software. One of the themes emerging from the data was the significance of maternal sounds. Both caregivers and mothers were able to articulate differences between adaptive and nonadaptive sounds according to their quality, pitch, feeling state, and accompanying verbalizations. Data about women's second stage labor sounds have been categorized according to the following maternal states: work/effort, coping, childlike, out-of-control, and with epidural anesthesia. Typical sounds/verbalization, significance, and facilitative caregiver responses are defined for each category. It is concluded that when a "no noise" rule is evoked during second stage labor, valuable behavioral cues are unavailable to guide caregiver behavior.