Devane Declan, Murphy-Lawless Jo, Begley Cecily M
School of Nursing and Midwifery, Trinity College Dublin, 24, D'Olier St, Dublin 2, Ireland.
Midwifery. 2007 Mar;23(1):92-101. doi: 10.1016/j.midw.2005.08.006. Epub 2006 May 4.
To describe the dominant policies and practices that have governed childbirth in Ireland, and to outline the progress made towards the introduction of midwifery-led care in one health region.
A review of maternity-care policies in Ireland was conducted using government and regional health-authority documents and two historical reviews of government policies. A search was also carried out in PubMed and cinahl databases, using the keywords 'maternity care', 'childbirth', 'policy', 'midwifery-led', 'Ireland/Irish', with relevant Boolean and string operands. Childbirth as a social process is influenced by the model of care, and affects the physical and psychological outcomes for the woman and her family. In Ireland, routine intervention in labour is common, but, since the early 1990s, some changes in the Irish maternity services have taken place. Pilot projects on community midwifery have been introduced in some areas. Challenges to the provision of maternity care in the Health Service Executive, North Eastern area (formerly the North-Eastern Health Board) led to the production of the Kinder report, which included a recommendation to introduce pilot midwifery-led units (MLUs). THE INTRODUCTION OF MIDWIFERY-LED CARE: A Maternity Services Taskforce was established in January 2002 with a wide remit, including facilitation of the establishment of MLUs in Cavan General Hospital, Cavan and Our Lady of Lourdes Hospital, Drogheda, Co. Louth. The MLUs are being evaluated within the context of a randomised trial known as 'the MidU study', which compares midwife-led care with the present system of medical-led care for women who are at low risk of complications during pregnancy and labour.
The journey to midwifery-led care in Ireland has been a long one. The phased introduction of MLUs, which are subject to rigorous evaluation, will provide quality evidence upon which to base the future development of maternity care across Ireland.
描述在爱尔兰主导分娩的主要政策和做法，并概述在一个卫生区域引入以助产士主导的护理方面所取得的进展。
利用政府和地区卫生当局文件以及对政府政策的两项历史回顾，对爱尔兰的孕产妇护理政策进行了综述。还在PubMed和CINAHL数据库中进行了检索，使用关键词“孕产妇护理”“分娩”“政策”“以助产士主导”“爱尔兰/爱尔兰的”以及相关的布尔和字符串操作符。分娩作为一个社会过程，受到护理模式的影响，并影响着产妇及其家庭的身体和心理结果。在爱尔兰，分娩时的常规干预很常见，但自20世纪90年代初以来，爱尔兰的孕产妇服务发生了一些变化。一些地区引入了社区助产士试点项目。卫生服务执行局东北地区（原东北卫生委员会）在提供孕产妇护理方面面临的挑战导致了《金德报告》的出台，该报告建议引入以助产士主导的试点单位（MLUs）。
2002年1月成立了一个孕产妇服务特别工作组，其职责广泛，包括推动在卡万综合医院、卡万以及卢尔德圣母医院、德罗赫达（劳斯郡）设立MLUs。这些MLUs正在一项名为“MidU研究”的随机试验背景下进行评估，该试验将助产士主导的护理与目前针对孕期和分娩期间并发症风险较低的女性的医疗主导护理系统进行比较。
爱尔兰迈向以助产士主导的护理的历程漫长。分阶段引入并经过严格评估的MLUs将提供高质量的证据，为爱尔兰未来孕产妇护理的发展提供依据。
