Homer Caroline S E, Davis Gregory K, Cooke Margaret, Barclay Lesley M
Division of Women's and Children's Health, St George Hospital, Kogarah, New South Wales 2217, Australia.
Midwifery. 2002 Jun;18(2):102-12. doi: 10.1054/midw.2002.0298.
to compare the experiences of women who received a new model of continuity of midwifery care with those who received standard hospital care during pregnancy, labour, birth and the postnatal period.
a randomised controlled trial was conducted. One thousand and eighty-nine women were randomly allocated to either the new model of care, the St George Outreach Maternity Project (STOMP), or standard care. Women completed a postal questionnaire eight to ten weeks after the birth.
women in the trial were of mixed obstetric risk status and more than half the sample were born in a non-English speaking country.
questionnaires were returned from 69% of consenting women. STOMP women were significantly more likely to have talked with their midwives and doctors about their personal preferences for childbirth and more likely to report that they knew enough about aspects of labour and birth, particularly induction of labour, pain relief and caesarean section. Almost 80% of women in the STOMP group experienced continuity of care, that is, one of their team midwives was present, during labour and birth. STOMP women reported a significantly higher 'sense of control during labour and birth'. Sixty-three per cent of STOMP women reported that they 'knew' the midwife who cared for them during labour compared with 21% of control women. In a secondary analysis, women who had a midwife during labour who they felt that they knew, had a significantly higher sense of 'control' and a more positive birth experience compared with women who reported an unknown midwife. Postnatal care elicited the greatest number of negative comments from women in both the STOMP and the control group.
The reorganisation of maternity services to enable women to receive continuity of care has benefits for women. The benefits of a known labour midwife needs further research.
比较接受新型助产护理模式的女性与在孕期、分娩期及产后接受标准医院护理的女性的经历。
进行了一项随机对照试验。1089名女性被随机分配到新型护理模式（圣乔治外展产妇项目，简称STOMP）或标准护理组。女性在产后八至十周完成一份邮寄问卷。
试验中的女性产科风险状况各异，超过半数的样本出生于非英语国家。
69%同意参与的女性返回了问卷。STOMP组的女性明显更有可能与助产士和医生谈论她们对分娩的个人偏好，并且更有可能报告她们对分娩和生产的各个方面了解充分，特别是引产、疼痛缓解和剖宫产。STOMP组近80%的女性在分娩和生产期间经历了连续性护理，即她们团队中的一名助产士在场。STOMP组的女性报告称在“分娩和生产期间的控制感”明显更高。63%的STOMP组女性报告称她们“认识”在分娩期间照顾她们的助产士，而对照组这一比例为21%。在一项二次分析中，与报告不认识助产士的女性相比，在分娩时有认识的助产士的女性“控制感”明显更高，分娩体验也更积极。产后护理在STOMP组和对照组女性中引发的负面评价最多。
对产科服务进行重组以使女性能够获得连续性护理对女性有益。熟悉的分娩助产士带来的益处需要进一步研究。
