Borders Noelle, Wendland Claire, Haozous Emily, Leeman Lawrence, Rogers Rebecca
Department of Obstetrics and Gynecology, Midwifery Division, MSC10 5580 1, University of New Mexico, Albuquerque NM 87131, USA.
J Obstet Gynecol Neonatal Nurs. 2013 May-Jun;42(3):311-20. doi: 10.1111/1552-6909.12028. Epub 2013 Apr 18.
To describe how nurse-midwives verbally support nulliparous women during second-stage labor and document specific details of each second stage.
Descriptive qualitative study.
A university hospital labor and delivery unit in the southwestern United States.
Nulliparous women (n = 14) older than age 18 and their attendant midwives (n = 9).
A single research midwife observed the entire second stage of each woman and used a standardized data collection form to record spontaneous or directed pushing, position changes, open and closed glottis pushing. A digital audio recorder was employed to capture verbal communication between the midwife and laboring woman. The research midwife and two qualitative experts employed content analysis to analyze the audio transcripts and identify categories of verbal support.
Analysis revealed four categories of verbal support: affirmation, information sharing, direction, and baby talk. The vast majority of verbal communication by nurse-midwives consisted of affirmation and information sharing. Nurse-midwives gave direction for specific reasons. Women pushed spontaneously the majority of the time, regardless of epidural use.
Nurse-midwives use a range of verbal support strategies to guide the second stage. Directive support was relatively uncommon. Most verbal support instead affirmed a woman's ability to follow her own body's lead in second-stage labor, with or without epidural.
描述助产士在第二产程中如何对初产妇提供言语支持，并记录每个第二产程的具体细节。
描述性定性研究。
美国西南部一家大学医院的分娩科室。
18岁以上的初产妇（n = 14）及其助产士（n = 9）。
一名研究助产士观察每位产妇的整个第二产程，并使用标准化数据收集表记录自发或指导下的用力情况、体位变化、屏气用力和不屏气用力情况。使用数字录音机记录助产士与产妇之间的言语交流。研究助产士和两名定性研究专家采用内容分析法对音频转录本进行分析，并确定言语支持的类别。
分析揭示了四类言语支持：肯定、信息共享、指导和婴儿语。助产士的绝大多数言语交流包括肯定和信息共享。助产士出于特定原因给予指导。无论是否使用硬膜外麻醉，产妇在大多数时间都是自发用力。
助产士使用一系列言语支持策略来指导第二产程。指导性支持相对较少见。大多数言语支持反而肯定了女性在第二产程中遵循自身身体引导的能力，无论是否使用硬膜外麻醉。
