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从业者认证以实践水中分娩:一项混合方法研究的结果。

Practitioner accreditation for the practice of water immersion during labour and birth: Results from a mixed methods study.

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. 2019 Jun;32(3):255-262. doi: 10.1016/j.wombi.2018.08.165. Epub 2018 Sep 5.

Abstract

BACKGROUND

Water immersion for labour and birth is an option that is increasingly favoured by women. Australian water immersion policies and guidelines commonly specify that practitioners, such as midwives, must undertake further education and training to become accredited.

METHOD

A three-phase mixed methods approach was used. Phase one used critical discourse analysis to determine who or what informs policies and guidelines related to water immersion for labour and/or birth. Phase two examined policy and guideline informants' experiences of the development of policies/guidelines, whilst phase three surveyed Australian midwives' views and experiences of water immersion and their use of and/or involvement in the development of policies and guidelines.

FINDINGS

Practitioner accreditation for the facilitation of water immersion was a common finding across all phases of the study. An examination of policies and guidelines found that practitioners, namely midwives, were required to meet additional training requirements to facilitate water immersion. Participants of phases two and three identified and discussed accreditation as a significant challenge to the option of water immersion, particularly where there were inconsistencies across documents and in the interpretation of their content.

CONCLUSION

The need for practitioners to be accredited to facilitate water immersion was identified as a major barrier to availability and therefore, women's ability to access the option. Given these findings, the need for accreditation should be challenged.

摘要

背景

水中分娩是一种越来越受女性欢迎的分娩方式。澳大利亚的水中分娩政策和指南通常规定,从业者(如助产士)必须接受进一步的教育和培训才能获得认证。

方法

采用三阶段混合方法。第一阶段使用批评性话语分析来确定哪些人或物影响了与水中分娩相关的政策和指南。第二阶段考察了政策和指南制定者在制定政策/指南方面的经验,而第三阶段则调查了澳大利亚助产士对水中分娩的看法和经验,以及他们对政策和指南的使用情况和/或参与情况。

发现

在研究的所有阶段,从业者(即助产士)的认证都是促进水中分娩的常见发现。对政策和指南的审查发现,从业者需要满足额外的培训要求才能促进水中分娩。第二阶段和第三阶段的参与者确定并讨论了认证是水中分娩选择的一个重大挑战,特别是在文件之间存在不一致和对其内容的解释不一致的情况下。

结论

需要从业者认证才能促进水中分娩被认为是可用性的主要障碍,因此,妇女获得该选择的能力受到限制。鉴于这些发现,应该对认证的必要性提出质疑。

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