Barking, Havering and Redbridge University Hospitals NHS Trust Flat 6 Taffeta House, 2 Penny Brookes St, London E20 1BL, UK.
School of Nursing, Program Director, Birth Partners, University of North Carolina at Chapel Hill, UNC Medical Center. Campus Box 7460, Chapel Hill, NC 27599, USA.
Midwifery. 2019 Oct;77:117-122. doi: 10.1016/j.midw.2019.07.001. Epub 2019 Jul 9.
Cesarean birth is common in the United States and associated with increased incidence of medical complications and maternal dissatisfaction. Doula support is associated with improved maternal and newborn outcomes but is often restricted to vaginal birth. The aim of this scoping study was to explore the experiences of volunteer doulas who provide support to women during cesarean birth.
Qualitative study using semi-structured interviews with nine doula volunteers from one program to assess their experiences caring for clients in the operating room (OR).
Doulas described their experiences supporting cesarean births in relation to four different relationship-level themes, relationships between: doulas and their clients (and clients' support persons); doulas and the physical environment (OR, labor and delivery unit); doulas and the OR interprofessional team; and doulas and the program culture. Doulas described perceived strengths and weaknesses of the OR-based program, and suggested improvements and future development opportunities.
Doulas volunteering within this program highly valued their perceived role in the care of women experiencing cesarean birth, including reports of increasing evidence-based practices such as SSC and early breastfeeding initiation in the OR. These doulas reported successfully working around the physically challenging OR environment and alongside the cesarean interprofessional team.
剖宫产在美国较为常见，与更多的医疗并发症和产妇不满有关。导乐支持与改善产妇和新生儿结局相关，但通常仅限于阴道分娩。本探索性研究的目的是探讨在剖宫产期间为妇女提供支持的志愿导乐的体验。
对来自一个项目的 9 名导乐志愿者进行了半结构化访谈的定性研究，以评估他们在手术室（OR）照顾客户的经验。
导乐围绕四个不同的关系层面主题描述了他们支持剖宫产的经验，这些主题涉及：导乐及其客户（和客户的支持人员）之间的关系；导乐与物理环境（OR、分娩室）之间的关系；导乐与 OR 跨专业团队之间的关系；以及导乐与项目文化之间的关系。导乐描述了基于 OR 的项目的优势和劣势，并提出了改进和未来发展机会。
在该项目中志愿参与的导乐高度重视他们在照顾经历剖宫产的妇女方面的作用，包括报告在 OR 中增加了基于证据的实践，如 SSC 和早期母乳喂养的启动。这些导乐报告说，他们成功地在具有挑战性的 OR 环境中以及在剖宫产跨专业团队中开展工作。
