Research blues

I realized yesterday, while attending my first research class, that I have done my first homework assignment for that class completely wrong. I thought we were supposed to come up with a topic that we wanted to research, i.e. do a literature review of all of the relevant articles out there, and see what’s currently being investigated about said topic. So, I blithely picked a topic that interested me, and thought I was good to go. Wrong. What we’re really supposed to do is come up with an idea for original research, and begin to draft a research proposal for said idea. This semester involves picking the problem we want to tackle, and doing the background research necessary to see what’s out there. Next semester will involve designing the study itself, and then writing it up into a proposal. Since we’re at the Master’s level and not the doctorate level, we won’t actually have to carry out the research, but by the time we’re finished, we should have a nice fat proposal that we could potentially send out for grants and sponsorship. It all sounds a bit daunting.

The topic I wanted to research was the 24 hour deadline held over women’s heads like a guillotine once their membranes have ruptured: deliver or else. The reason given for this 24 hour rule is that supposedly the inicidence of chorioamnionitis (an infection of the placenta and membranes) increases drastically after 24 hours, especially if the woman is Group Beta strep positive, and this infection can be dangerous for both the mother and baby. I have never looked at the hard numbers on this, though. I wonder what the rate of infection is, and if it really merits such a sharp deadline. I have seen many deliveries where the woman is still asymptomatic at 24 hours, afebrile and not showing any signs of infection, but her doctor urges a c-section on her anyway instead of allowing her to continue to labor. I wonder if the research really backs up such decision making. My instinct is that the clock ticks much more impatiently on women with ruptured membranes, and that this urgency and impatience, which is then used to justify inductions, augmentations and cesareans, is not actually necessary. I have no idea if this suspician is true, though. That’s what I wanted to investigate.

However, investigating this is just a simple matter of doing a literature review. It’s not a research design or proposal, and I can’t for the life of me think of a research study I could perform that could measure this, or contribute in a meaningful way to the literature. Doing a randomized control trial is not really an option. This doesn’t have much to do with midwifery, anyway. It’s more of a hard science, obstetrical connundrum, and I would rather do something more midwifery related.

So, back to the drawing board. Any suggestions on research proposals? It will require a lot more thinking.

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