McLeish Jenny, Redshaw Maggie
Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
Midwifery. 2018 Jan;56:53-60. doi: 10.1016/j.midw.2017.10.002. Epub 2017 Oct 6.
to explore trained volunteer doulas' and mothers' experiences of doula support at birth and their perceptions of how this related to the midwife's role.
a qualitative descriptive study, informed by phenomenological social psychology.
semi-structured interviews were carried out between June 2015 and March 2016. Interview transcripts were analysed using inductive thematic analysis.
three community volunteer doula projects run by third sector organisations in England.
19 volunteer doulas and 16 mothers who had received doula support during labour.
three overarching themes emerged: (1) 'the doula as complementary to midwives', containing subthemes 'skilled physical and emotional support', 'continuous presence', 'woman-centred support', 'ensuring mothers understand and are understood' and 'creating a team for the mother'; (2)'the doula as a colleague to midwives', containing subthemes 'welcomed as a partner', 'co-opted to help the midwives', and 'doulas identify with the midwives'; and (3) 'the doula as challenge to midwives', containing subthemes 'confusion about the doula's role', 'defending informed choice', and 'counterbalancing disempowering treatment'. KEY CONCLUSIONS&IMPLICATIONS FOR PRACTICE: volunteer doulas can play an important role in improving women's birth experiences by offering continuous, empowering, woman-focused support that complements the role of midwives, particularly where the mothers are disadvantaged. Greater clarity is needed about the scope of legitimate volunteer doula advocacy on behalf of their clients, to maximise effective working relationships between midwives and doulas.
探讨受过培训的志愿者导乐及产妇在分娩时获得导乐支持的经历，以及她们对这与助产士角色之间关系的看法。
一项基于现象学社会心理学的定性描述性研究。
于2015年6月至2016年3月期间进行半结构式访谈。采用归纳主题分析法对访谈记录进行分析。
英格兰由第三部门组织运营的三个社区志愿者导乐项目。
19名志愿者导乐和16名在分娩期间接受过导乐支持的产妇。
出现了三个总体主题：（1）“导乐作为助产士的补充”，包含子主题“熟练的身体和情感支持”“持续陪伴”“以产妇为中心的支持”“确保产妇理解并被理解”以及“为产妇组建团队”；（2）“导乐作为助产士的同事”，包含子主题“作为伙伴受到欢迎”“被吸纳来帮助助产士”以及“导乐认同助产士”；（3）“导乐对助产士的挑战”，包含子主题“对导乐角色的困惑”“捍卫知情选择”以及“平衡剥夺权利的治疗”。关键结论及对实践的启示：志愿者导乐通过提供持续、赋权且以产妇为中心的支持来补充助产士的角色，在改善产妇分娩体验方面可发挥重要作用，尤其是在产妇处于不利地位的情况下。需要更明确志愿者导乐代表其客户进行合法倡导的范围，以最大限度地优化助产士与导乐之间的有效工作关系。
