School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
National Maternity Hospital, Dublin, Ireland.
Midwifery. 2020 Nov;90:102817. doi: 10.1016/j.midw.2020.102817. Epub 2020 Aug 11.
The overall aim of this study was to collate information to inform the updating of a perineal management educational programme for midwives. This paper explores midwives' confidence and educational needs in managing the woman's perineum during the second stage of labour, focusing on future quality initiatives to improve midwives' experiences and expertise in the prevention of perineal trauma during birth.
A mixed-methods sequential exploratory design was used.
Midwives and clinical midwife managers assisting with births in the labour ward of a large urban university stand-alone maternity hospital in the Republic of Ireland with approximately 9,000 births per year participated in the study.
A questionnaire and two focus groups were used to collect the data.
Fifty-two midwives from a total of 64 eligible labour ward midwives completed the questionnaire, a response rate of 81.2%. Midwives indicated that perineal management workshops did not cover prevention of perineal trauma, and mainly focused on suturing and repair of the perineum. The majority of midwives (85%) indicated that they would like further education on the prevention of perineal trauma. Higher levels of confidence in making a decision to perform an episiotomy, infiltrating the perineum and at performing an episiotomy were reported in experienced midwives. Midwives want improved and additional education in the management of women's perinea during the second stage of labour and made various recommendations regarding the content, format, timing and frequency of the workshop. Suggestions for further education included techniques for preventing perineal trauma during labour and birth and how to perform an episiotomy.
This study provides key insights into midwives' confidence and educational needs in relation to managing the woman's perineum during the second stage of labour. The findings from this study demonstrates the appetite of midwives for additional education in the area of perineal management, particularly prevention strategies.
Midwives play an essential role in reducing the rates of perineal trauma through regular education. It is therefore important that midwives keep up to date with the best available evidence. Updating existing perineal management educational programmes that are tailor made to midwives' needs could not only improve clinical skills and perineal protection techniques but also midwives' confidence in decision making. The overall aim is to reduce perineal trauma in women having a spontaneous vaginal birth.
本研究的总体目标是整理信息，为更新助产士会阴管理教育计划提供依据。本文探讨了助产士在分娩第二阶段管理产妇会阴的信心和教育需求，重点关注未来的质量举措，以提高助产士在分娩过程中预防会阴创伤的经验和专业知识。
混合方法序贯探索性设计。
在爱尔兰共和国的一个大型城市独立妇产医院的产房协助分娩的助产士和临床助产士经理参与了这项研究，该医院每年约有 9000 名婴儿出生。
使用问卷和两个焦点小组收集数据。
在总共 64 名符合条件的产房助产士中，有 52 名助产士完成了问卷，回应率为 81.2%。助产士表示，会阴管理讲习班没有涵盖预防会阴创伤，主要集中在会阴缝合和修复上。大多数助产士（85%）表示希望进一步接受预防会阴创伤的教育。经验丰富的助产士在决定行会阴切开术、会阴浸润和行会阴切开术方面表现出更高的信心。助产士希望在分娩第二阶段改善和增加对妇女会阴部管理的教育，并就讲习班的内容、形式、时间和频率提出了各种建议。进一步教育的建议包括在分娩和分娩期间预防会阴创伤的技术以及如何行会阴切开术。
本研究提供了关键的见解，了解助产士在分娩第二阶段管理产妇会阴方面的信心和教育需求。这项研究的结果表明，助产士对会阴管理领域的额外教育有需求，特别是预防策略。
助产士通过定期教育在降低会阴创伤率方面发挥着至关重要的作用。因此，助产士必须掌握最新的最佳证据。更新现有的会阴管理教育计划，这些计划是根据助产士的需求量身定制的，不仅可以提高临床技能和会阴保护技术，还可以提高助产士在决策方面的信心。总体目标是减少自然阴道分娩妇女的会阴创伤。
