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以全新视角看待分娩:接触家庭分娩对医院助产士的变革性影响。

Seeing birth in a new light: The transformational effect of exposure to homebirth for hospital-based midwives.

作者信息

Coddington Rebecca, Catling Christine, Homer Caroline

机构信息

Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo NSW 2007, Australia.

Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo NSW 2007, Australia.

出版信息

Midwifery. 2020 Sep;88:102755. doi: 10.1016/j.midw.2020.102755. Epub 2020 May 23.

DOI:10.1016/j.midw.2020.102755
PMID:32497819
Abstract

OBJECTIVE

The aim of the study was to explore hospital-based midwives' experiences of providing publicly-funded homebirth services in Australia.

DESIGN

A qualitative descriptive study using a constructivist grounded theory methodology was undertaken.

SETTING

Five different states or territories of Australia where publicly-funded homebirth services were operating.

PARTICIPANTS

Interviews were conducted with 21 midwives and midwifery managers from eight different public hospitals who had recent experience of working in, or with, publicly-funded homebirth models.

FINDINGS

Witnessing undisturbed birth in the home setting transformed midwives' attitudes towards birth. Following exposure to homebirth, many midwives felt they were seeing undisturbed birth for the first time. This led them to question their current understanding of physiological birth and develop a new awareness of the powerful influence that the environment has on labouring women. This new understanding resulted in changes to their practice.

KEY CONCLUSIONS

For midwives accustomed to working in hospital settings, exposure to homebirth deepened their understanding of physiological birth, resulting in a perspective transformation and subsequent shift in practice.

IMPLICATIONS FOR PRACTICE

Exposure to homebirth may motivate midwives to alter their practice in both home and hospital settings in order to shift the power dynamic between women and caregivers and protect women from unnecessary disturbance during labour.

摘要

目的

本研究旨在探索澳大利亚医院助产士提供公共资助家庭分娩服务的经历。

设计

采用建构主义扎根理论方法进行定性描述性研究。

地点

澳大利亚五个提供公共资助家庭分娩服务的不同州或领地。

参与者

对来自八家不同公立医院的21名助产士和助产士管理人员进行了访谈,他们近期有在公共资助家庭分娩模式下工作或与之合作的经历。

研究结果

在家中见证自然分娩改变了助产士对分娩的态度。接触家庭分娩后,许多助产士觉得自己第一次看到了自然分娩。这使他们质疑自己对生理性分娩的现有理解,并对环境对产妇分娩的强大影响有了新的认识。这种新认识导致了他们实践的改变。

主要结论

对于习惯在医院环境中工作的助产士来说,接触家庭分娩加深了他们对生理性分娩的理解,导致了观念转变以及随后实践的转变。

对实践的启示

接触家庭分娩可能促使助产士改变在家庭和医院环境中的实践方式,以改变女性与护理人员之间的权力动态,并保护女性在分娩期间免受不必要的干扰。

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