CAPHRI School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands.
Research Center for Midwifery Science, Zuyd University of Applied Sciences, Maastricht, The Netherlands.
J Midwifery Womens Health. 2019 Sep;64(5):641-648. doi: 10.1111/jmwh.12999. Epub 2019 Jun 24.
Women want positive birth experiences with high quality maternity care that is neither too much, too soon, nor too little, too late. Research confirms the effectiveness of midwifery care, and the midwifery approach to birth as physiologic may counter the upward trend of the unnecessary medicalization of birth. The role of guardian of physiologic birth is seen as central to midwifery practice; however, medical hegemony has led to the subordination of midwives, which inhibits them in fulfilling the role as guardian of physiologic birth. Learning to become powerful advocates of physiologic birth creates midwives able to speak up for effective, evidence-based maternity care and challenge the unnecessary use of obstetric intervention. Midwifery education has a role to fulfil in molding midwives who are able to assume this role. This brief report describes the development of an educational prototype aimed at increasing student midwife agency as an advocate of physiologic birth. This was done using rapid prototyping (RP) methodology, in which important stakeholders gave input and feedback during the educational design and development process. Input from stakeholders led to the inclusion of persuasive communication strategies and discussion and debate as teaching methodologies in order to increase student midwife agency to argue for physiologic birth. Reflective evidence-based practice, using the Optimality Index-Netherlands, allowed students to reflect on their practice while providing a framework for discussion. Working with the RP methodology allowed for the development of a prototype that reflected the needs of midwifery stakeholders and was mindful of material and human resources.
女性希望在高质量的产妇护理下拥有积极的分娩体验，这种护理既不过多、过早，也不过少、过晚。研究证实了助产护理的有效性，而助产士以生理为导向的分娩方法可能会抵制分娩不必要的医学化趋势。守护生理性分娩的角色被视为助产实践的核心；然而，医学霸权导致了助产士的从属地位，这阻碍了他们履行守护生理性分娩的角色。学会成为生理性分娩的有力倡导者，可以培养出能够为有效的、基于证据的产妇护理发声并挑战不必要的产科干预的助产士。助产教育在培养能够承担这一角色的助产士方面发挥着作用。本简要报告描述了开发教育原型的过程，旨在提高学生助产士作为生理性分娩倡导者的代理权。这是通过快速原型（RP）方法完成的，在这个方法中，重要的利益相关者在教育设计和开发过程中提供了投入和反馈。利益相关者的投入导致了劝导性沟通策略的纳入，以及讨论和辩论作为教学方法，以增加学生助产士代理生理性分娩的能力。使用优化指数-荷兰进行的基于反思的循证实践允许学生反思自己的实践，同时为讨论提供了一个框架。使用 RP 方法可以开发出一个反映助产士利益相关者需求的原型，并考虑到材料和人力资源。
