Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China.
Delivery Room, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China.
BMC Pregnancy Childbirth. 2021 Feb 19;21(1):151. doi: 10.1186/s12884-021-03638-3.
Low risk pregnancy ending in a vaginal birth is best served and guided by a midwife. Utilizing a midwife in such cases offers many emotional and economic advantages and does not increase the risks for mother or neonate. However, women's experience and satisfaction of midwife-led maternity care is rarely reported in China. The primary objective of this study is to describe the experience of Chinese women receiving midwife-led maternity care, and to report their satisfaction level of the experience.
The study is a cross-sectional survey of 4192 women who had natural birth from March-June 2019 in a maternity care center, Shanghai, China. We used a self-administered questionnaire addressing items related to women's experience during childbirth, as well as their satisfaction with midwife-led maternity care. We also included demographic and perinatal characteristics of each participant. Descriptive statistics and correlations analysis between groups of different experience and satisfaction were used.
In this sample, 87.7% of women had a Doula and a family member present during childbirth. Epidural anesthesia was used in 75.6% and episiotomy was needed in 23.2%. Free positioning during the first stage of labor and free positioning during the second stage of labor and delivery were adopted in 84.3 and 67.9% of the cases, respectively. Moderate to severe perineal pain and moderate to severe perineal edema were reported in 43.1 and 12.2% of the participants, respectively. High satisfaction level was found when there was midwife-led prenatal counseling and presence of Doula and family member, Lamaze breathing techniques, warm perineal compresses, epidural anesthesia, free positioning during the first stage of labor, and midwifes' postpartum guidance. Negative satisfaction was seen with perineal pain and edema.
Women in this survey generally had high satisfaction with midwife-led maternity care. This satisfaction is probably felt because of the prenatal counseling by the midwife and allowing a Doula and a family member in the room during childbirth. Other intangible factors to improve the satisfaction level were Lamaze breathing techniques, warm perineal compresses, epidural anesthesia, free positioning during first stage of labor, and early skin to skin contact.
低风险妊娠以阴道分娩结束时，最好由助产士提供服务和指导。在这种情况下使用助产士可以带来许多情感和经济上的优势，并且不会增加母婴的风险。然而，中国很少有关于女性体验和对助产士主导的产时护理满意度的报告。本研究的主要目的是描述中国女性接受助产士主导的产时护理的体验，并报告她们对这种体验的满意度。
这是一项横断面调查研究，共纳入 2019 年 3 月至 6 月在上海一家妇幼保健中心自然分娩的 4192 名女性。我们使用了一份自我管理问卷，其中包含与分娩期间女性体验相关的项目，以及她们对助产士主导的产时护理的满意度。我们还包括了每位参与者的人口统计学和围产期特征。使用描述性统计和相关性分析比较不同体验和满意度组之间的差异。
在本样本中，87.7%的女性在分娩时有导乐陪伴和家庭成员在场。75.6%的女性使用了硬膜外麻醉，23.2%的女性需要会阴切开术。84.3%的女性在第一产程中采用自由体位，67.9%的女性在第二产程和分娩中采用自由体位。43.1%的参与者报告中度至重度会阴疼痛，12.2%的参与者报告中度至重度会阴水肿。当有助产士主导的产前咨询、导乐和家庭成员在场、拉玛泽呼吸技巧、温暖的会阴压迫、硬膜外麻醉、第一产程中的自由体位以及助产士的产后指导时，满意度较高。当出现会阴疼痛和水肿时，满意度较低。
本调查中的女性对助产士主导的产时护理总体满意度较高。这种满意度可能是由于助产士的产前咨询以及允许导乐和家庭成员在分娩时在场。提高满意度的其他无形因素包括拉玛泽呼吸技巧、温暖的会阴压迫、硬膜外麻醉、第一产程中的自由体位以及早期的皮肤接触。
