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澳大利亚助产士对水中分娩相关实践和政治的看法和经验:一项基于网络的调查。

Australian midwives views and experiences of practice and politics related to water immersion for labour and birth: A web based survey.

机构信息

School of Nursing and Midwifery, University of South Australia, City East Campus, Adelaide, South Australia, Australia.

School of Nursing and Midwifery, University of South Australia, City East Campus, Adelaide, South Australia, Australia.

出版信息

Women Birth. 2018 Jun;31(3):184-193. doi: 10.1016/j.wombi.2017.09.001. Epub 2017 Oct 13.

Abstract

BACKGROUND

There is little published research that has examined practitioners' views and experiences of pain relieving measures commonly used during labour and birth, particularly for non-pharmacological measures such as water immersion. Furthermore, there is minimal published research examining the process of policy and guideline development, that is, the translation of published research to usable practice guidance.

AIMS

The aims of phase three of a larger study were to explore midwives knowledge, experiences and support for the option of water immersion for labour and birth in practice and their involvement, if any, in development of policy and guidelines pertaining to the option.

METHODS

Phase three of a three phased mixed methods study included a web based survey of 234 Australian midwives who had facilitated and/or been involved in the development of policies and/or guidelines relating to the practice of water immersion.

FINDINGS

Midwives who participated in this study were supportive of both water immersion for labour and birth reiterating documented benefits of reduced pain, maternal relaxation and a positive birth experience. The most significant concerns were maternal collapse, the difficulty of estimating blood loss and postpartum haemorrhage whilst barriers included lack of accredited staff, lifting equipment and negative attitudes. Midwives indicated that policy/guideline documents limited their ability to facilitate water immersion and did not always to support women's informed choice.

CONCLUSION

Midwives who participated in this study supported the practice of water immersion reiterating the benefits documented in the literature and minimal risk to the woman and baby.

ETHICAL CONSIDERATIONS

The Human Research Ethics Committee of the University of South Australia approved the research.

摘要

背景

几乎没有发表的研究探讨过从业者对分娩过程中常用的止痛措施(尤其是非药物性措施,如水中分娩)的看法和经验,特别是针对水中分娩。此外,很少有发表的研究探讨政策和指南制定的过程,即把已发表的研究转化为可应用于实践的指导意见。

目的

这项更大规模研究的第三阶段旨在探讨助产士对水中分娩选择的知识、经验和支持情况,以及他们在制定与该选择相关的政策和指南方面的参与情况。

方法

这是一个三阶段混合方法研究的第三阶段,包括对 234 名澳大利亚助产士进行了一项基于网络的调查,这些助产士曾协助制定和/或参与制定与水中分娩实践相关的政策和/或指南。

结果

参与本研究的助产士对分娩时使用水中分娩表示支持,并重申了减少疼痛、产妇放松和积极分娩体验的已有文献记载的益处。最主要的担忧是产妇晕倒、难以估计出血量和产后出血,而障碍包括缺乏经过认证的员工、起重设备和负面态度。助产士表示,政策/指南文件限制了他们促进水中分娩的能力,并不总是支持妇女的知情选择。

结论

参与本研究的助产士支持水中分娩实践,重申了文献中记载的益处,而且对妇女和婴儿的风险极小。

伦理考虑

南澳大利亚大学的人类研究伦理委员会批准了这项研究。

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