Geburtshaus Kreuzberg, Müllenhoffstr. 17, 10967 Berlin, Germany.
Midwifery. 2012 Oct;28(5):568-75. doi: 10.1016/j.midw.2012.04.005. Epub 2012 Aug 29.
the practical training in midwifery education in Germany takes place predominantly in hospital delivery wards, where high rates of intervention and caesarean section prevail. When midwives practice birth assistance at free-standing birth centres, they have to make adjustments to what they learned in the clinic to support women without the interventions common to hospital birth.
the primary aim of this study was to investigate and describe the approach of midwives practicing birth assistance at a free-standing birth centre.
a qualitative approach to data collection and analysis with grounded theory was used which included semi-structured expert interviews and participant observation. Five midwives were interviewed and nine births observed in the research period. The setting was a free-standing birth centre in a large German city with approximately 115 births per year.
the midwives all had to re-learn birth assistance when commencing work outside of the hospital. However, having been trained predominantly in hospital maternity wards, they have retained many aspects characteristic of their training. The midwives use technology, although minimal, and medical discourse in combination with 1:1, woman-centred care. The birthing woman and midwife share authority at birth. The fetus is treated as an ally of the mother, suited for birth and cooperative. Through use of objective and subjective criteria, the midwives have their own approach to making physiological birth possible.
to prepare midwives to support low-intervention birth, it is necessary to include training in birth assistance with women who birth physiologically, without interventions common to hospital birth. The results of this study would also suggest that the rate of interventions in hospital could be reduced if midwives gain more experience with women birthing without the above-mentioned interventions.
德国的助产学教育中的实践培训主要在医院的分娩病房进行，那里普遍存在较高的干预率和剖宫产率。当助产士在独立的分娩中心进行分娩协助时，他们必须调整在诊所中学到的知识，以支持没有医院分娩常见干预的女性。
本研究的主要目的是调查和描述在独立分娩中心从事分娩协助的助产士的方法。
使用定性方法收集和分析数据，并采用扎根理论，包括半结构化专家访谈和参与观察。在研究期间，采访了 5 名助产士并观察了 9 次分娩。研究地点是德国一个大城市的一个独立分娩中心，每年约有 115 次分娩。
助产士在离开医院开始工作时都必须重新学习分娩协助。然而，由于他们主要在医院的产科病房接受培训，因此保留了许多与其培训相关的特征。助产士会使用技术，尽管很少，但会将其与 1:1、以妇女为中心的护理相结合。产妇和助产士在分娩时共同拥有权力。胎儿被视为母亲的盟友，适合分娩并具有合作性。通过使用客观和主观标准，助产士对实现生理分娩有自己的方法。
为了使助产士能够支持低干预分娩，有必要包括对自然分娩、无医院分娩常见干预的女性进行分娩协助培训。本研究的结果还表明，如果助产士在没有上述干预的情况下有更多分娩经验，医院的干预率可能会降低。
