Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan.
Int J Evid Based Healthc. 2011 Mar;9(1):25-31. doi: 10.1111/j.1744-1609.2010.00197.x.
In 1996, the World Health Organization stated that 'childbirth is a natural process and in normal birth, there should be a valid reason to interfere with this natural process' and encouraged practices that are evidence-based. The practices encouraged included avoiding unnecessary augmentation of labour, facilitating upright position for birth and restricting the use of routine episiotomy. Many countries have been slow to fully implement evidence-based practice in maternity care. The aim of this study was to examine maternity hospital practices in Jordan and assess their consistency with evidence-based maternity care.
An explorative research design with non-participant observation was used. Data were collected from low-risk women during labour and birth using a questionnaire for maternal characteristics and an observational checklist. A proportional stratified sample was selected to recruit from three major public hospitals in Jordan. Data were analysed using descriptive statistics.
A total of 460 women were observed during labour and birth. The majority were multiparous (80%). A range of interventions were observed in women having a normal labour including augmentation (95%), continuous external fetal monitoring (77%), lithotomy position for birth (100%), and more than one third (37%) had an episiotomy with varying degrees of laceration (58%).
Childbirth practices were largely not in accordance with the World Health Organization evidence-based practices for normal birth. High levels of interventions were observed, many of which may not have been necessary in this low-risk population. Further work needs to occur to explore the reasons why evidence-based practice is not implemented in these hospitals.
1996 年，世界卫生组织指出“分娩是一个自然的过程，在正常分娩中，应该有合理的理由来干预这个自然过程”，并鼓励基于证据的实践。鼓励的实践包括避免不必要的劳动增强、促进分娩时的直立姿势和限制常规会阴切开术的使用。许多国家在产科护理中实施基于证据的实践方面进展缓慢。本研究旨在检查约旦的产科医院实践，并评估其与基于证据的产科护理的一致性。
采用非参与式观察的探索性研究设计。使用产妇特征问卷和观察检查表，从低风险产妇在分娩期间收集数据。采用比例分层抽样，从约旦的三家主要公立医院中招募参与者。使用描述性统计方法分析数据。
共观察了 460 名分娩的妇女。大多数是经产妇（80%）。在正常分娩的妇女中观察到一系列干预措施，包括催产（95%）、连续外部胎儿监测（77%）、分娩时截石位（100%），超过三分之一（37%）的妇女接受了会阴切开术，会阴裂伤程度不一（58%）。
分娩实践在很大程度上不符合世界卫生组织关于正常分娩的基于证据的实践。观察到高水平的干预措施，其中许多在这个低风险人群中可能没有必要。需要进一步开展工作，探讨这些医院不实施基于证据的实践的原因。
