School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, Western Australia, 6102, Australia.
Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, 6008, Australia.
BMC Pregnancy Childbirth. 2018 Jun 19;18(1):249. doi: 10.1186/s12884-018-1823-0.
There is limited research examining midwives' education, knowledge and practice around immersion in water for labour or birth. Our aim was to address this gap in evidence and build knowledge around this important topic.
This mixed method study was performed in two phases, between August and December 2016, in the birth centre of a tertiary public maternity hospital in Western Australia. Phase one utilised a cross sectional design to examine perceptions of education, knowledge and practice around immersion in water for labour or birth through a questionnaire. Phase two employed a qualitative descriptive design and focus groups to explore what midwives enjoyed about caring for women who labour or birth in water and the challenges midwives experienced with waterbirth. Frequency distributions were employed for quantitative data. Thematic analysis was undertaken to extract common themes from focus group transcripts.
The majority (85%; 29 of 34) of midwives surveyed returned a questionnaire. Results from phase one confirmed that following training, 93% (27 of 29) of midwives felt equipped to facilitate waterbirth and the mean waterbirths required to facilitate confidence was seven. Midwives were confident caring for women in water during the first, second and third stage of labour and enjoyed facilitating water immersion for labour and birth. Finally, responses to labour and birth scenarios indicated midwives were practicing according to state-wide clinical guidance. Phase two included two focus groups of seven and five midwives. Exploration of what midwives enjoyed about caring for women who used water immersion revealed three themes: instinctive birthing; woman-centred atmosphere; and undisturbed space. Exploration of the challenges experienced with waterbirth revealed two themes: learning through reflection and facilities required to support waterbirth.
This research contributes to the growing knowledge base examining midwives' education, knowledge and practice around immersion in water for labour or birth. It also highlights the importance of exploring what immersion in water for labour and birth offers midwives, as this research suggests they are integral to sustaining waterbirth as an option for low risk women.
目前，关于助产士在水中分娩或待产方面的教育、知识和实践的研究有限。我们旨在填补这一证据空白，并围绕这一重要主题增加知识储备。
这项混合方法研究分两个阶段进行，于 2016 年 8 月至 12 月在西澳大利亚州一家三级公立医院的分娩中心进行。第一阶段采用横断面设计，通过问卷调查了解助产士对水中分娩的教育、知识和实践的看法。第二阶段采用定性描述性设计和焦点小组探讨助产士在水中照顾分娩或待产妇女的乐趣以及助产士在水中分娩方面面临的挑战。对定量数据采用频率分布。从焦点小组记录中提取共同主题进行主题分析。
接受调查的助产士中，有 85%（29/34）返回了问卷。第一阶段的结果证实，在接受培训后，93%（27/29）的助产士认为自己有能力促进水中分娩，而需要促进信心的平均水中分娩次数为 7 次。助产士在分娩的第一、第二和第三阶段对在水中的妇女有信心，并喜欢促进分娩和分娩的水中浸入。最后，对分娩和分娩场景的反应表明，助产士正在按照全州范围的临床指导进行实践。第二阶段包括两个 7 人和 5 名助产士的焦点小组。探讨助产士在水中照顾产妇的乐趣时，发现了三个主题：本能分娩；以妇女为中心的氛围；以及不受干扰的空间。探讨水中分娩所面临的挑战时发现了两个主题：通过反思学习和支持水中分娩所需的设施。
这项研究有助于增加关于助产士在水中分娩或待产方面的教育、知识和实践的知识基础。它还强调了探讨水中分娩为助产士带来的好处的重要性，因为这项研究表明，助产士是维持水中分娩作为低风险妇女选择的关键。
