Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
Women's and Children's health, Karolinska Institute, Stockholm, Sweden.
BMJ Open. 2020 Feb 18;10(2):e031290. doi: 10.1136/bmjopen-2019-031290.
Migrant women consistently rate their care during labour and birth more negatively than non-migrant women, due to communication difficulties, lack of familiarity with how care is provided, and discrimination and prejudicial staff attitudes. They also report being left alone, feeling fearful, unsafe and unsupported, and have poorer birth outcomes than non-migrant women. Community-based doulas (CBDs) are bilingual women from migrant communities who are trained in childbirth and labour support, and who facilitate communication between woman-partner-staff during childbirth. This study protocol describes the design, rationale and methods of a randomised controlled trial that aims to evaluate the effectiveness of CBD support for improving the intrapartum care experiences and postnatal well-being of migrant women giving birth in Sweden.
A randomised controlled trial. From six antenatal care clinics in Stockholm, Sweden, we aim to recruit 200 pregnant Somali, Arabic, Polish, Russian and Tigrinya-speaking women who cannot communicate fluently in Swedish, are 18 years or older and with no contraindications for vaginal birth. In addition to standard labour support, women are randomised to CBD support (n=100) or no such support during labour (n=100). Trained CBDs meet with women once or twice before the birth, provide emotional, physical and communication support to women throughout labour and birth in hospital, and then meet with women once or twice after the birth. Women's ratings of the intrapartum care experiences and postnatal well-being are assessed at 6-8 weeks after the birth using selected questions from the Migrant Friendly Maternity Care Questionnaire and by the Edinburgh Postnatal Depression Scale. The intervention group will be compared with the control group using intention-to-treat analyses. ORs and 95% CIs will be estimated and adjustments made if key participant characteristics differ between trial arms.
The study was approved by the Regional Ethical Review Board in Stockholm (approval number: 2018/12 - 31/2).
NCT03461640; Pre-results.
移民妇女在分娩和生育期间的护理评价普遍比非移民妇女更差，这是由于沟通困难、不熟悉护理方式以及医护人员的歧视和偏见态度。她们还报告说感到孤独、恐惧、不安全和不受支持，并且分娩结果不如非移民妇女。社区导乐（CBD）是来自移民社区的双语女性，她们接受过分娩和生育支持方面的培训，并在分娩期间促进妇女-伴侣-工作人员之间的沟通。本研究方案描述了一项随机对照试验的设计、原理和方法，该试验旨在评估 CBD 支持对改善在瑞典分娩的移民妇女分娩期间护理体验和产后幸福感的有效性。
一项随机对照试验。我们将从瑞典斯德哥尔摩的六家产前护理诊所招募 200 名不能流利地用瑞典语交流的索马里语、阿拉伯语、波兰语、俄语和提格雷语的孕妇，年龄在 18 岁及以上，并且没有阴道分娩的禁忌症。除了标准的分娩支持外，女性还被随机分配到 CBD 支持组（n=100）或分娩期间不接受此类支持的对照组（n=100）。经过培训的 CBD 会在分娩前与女性会面一次或两次，在医院分娩和分娩期间为女性提供情感、身体和沟通支持，然后在分娩后与女性会面一次或两次。在分娩后 6-8 周，使用移民友好型产妇护理问卷中的选定问题和爱丁堡产后抑郁量表评估女性的分娩期间护理体验和产后幸福感。将使用意向治疗分析比较干预组和对照组。将估计 OR 和 95%CI，并在试验臂之间关键参与者特征存在差异时进行调整。
该研究得到了斯德哥尔摩地区伦理审查委员会的批准（批准号：2018/12-31/2）。
NCT03461640；预结果。
