Aalborg University Hospital, Department of Gynecology and Obstetrics, Labor Ward, Reberbansgade, Postboks 561, 9100 Aalborg, Denmark; University College of Northern Denmark, Department of Midwifery, Selma Lagerloefs Vej 2, 9220 Aalborg, Denmark.
Aalborg University, Department of Learning and Philosophy, Sohngaardsholmsvej 2, 9000 Aalborg, Denmark.
Women Birth. 2014 Jun;27(2):98-103. doi: 10.1016/j.wombi.2014.01.005. Epub 2014 Mar 4.
There is a lack of literature about what constitutes good midwifery care for women who have epidural analgesia during labour. It is known that an increasing number of women receive epidural analgesia for labour pain. We also know that while women rate the painkilling effect of the epidural analgesia as high, in general, their satisfaction with labour is unchanged or even lower when epidural analgesia is used.
How do women experience being in labour with epidural analgesia, and what kind of midwifery care do they, consequently, need?
A field study and semi-structured interviews were conducted on a phenomenological basis. Nine nulliparous women were observed from initiation of epidural analgesia until birth of their baby. They were interviewed the day after the birth and again 2 months later. The involved midwives were interviewed 2-3h after the birth.
Initiation of epidural analgesia can have considerable implications for women's experience of labour. Two different types of emotional reactions towards epidural analgesia are distinguished, one of which is particularly marked by a subtle sense of worry and ambivalence. Another important finding refers to the labouring woman's relationship with the midwife, which represents an essential influencing factor on the woman' experience of labour. Within this relationship, some rather unnoticed matters of communication and recognition appear to be of decisive significance.
After initiation of epidural analgesia the requirements of midwifery care seem to go beyond how women verbalise and define their own needs. The midwife should be attentive to the labouring woman's type of emotional reaction to epidural analgesia and her possible intricate worries.
关于硬膜外分娩镇痛产妇的优质助产护理内容，相关文献较少。众所周知，越来越多的产妇在分娩时选择硬膜外镇痛。我们还知道，尽管产妇对硬膜外镇痛的止痛效果评价较高，但当使用硬膜外镇痛时，她们对分娩的总体满意度不变甚至更低。
使用硬膜外镇痛分娩的产妇有何体验，她们需要什么样的助产护理？
基于现象学方法，进行了一项实地研究和半结构化访谈。从硬膜外镇痛开始到婴儿出生，观察了 9 名初产妇。她们在分娩后第二天和 2 个月后接受了访谈。涉及的助产士在分娩后 2-3 小时接受了访谈。
硬膜外镇痛的开始会对产妇的分娩体验产生重大影响。区分出两种不同类型的对硬膜外镇痛的情绪反应，其中一种反应尤其以微妙的担忧和矛盾情绪为特征。另一个重要的发现是指产妇与助产士的关系，这是对女性分娩体验产生重要影响的因素。在这种关系中，一些看似微不足道的沟通和认可事项似乎具有决定性的意义。
在开始硬膜外镇痛后，助产护理的要求似乎超出了产妇口头表达和定义自身需求的范围。助产士应该注意到产妇对硬膜外镇痛的情绪反应类型及其可能存在的复杂担忧。
