Fox Deborah, Scarf Vanessa, Turkmani Sabera, Rossiter Chris, Coddington Rebecca, Sheehy Annabel, Catling Christine, Cummins Allison, Baird Kathleen
Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Australia.
Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Australia.
Women Birth. 2023 Mar;36(2):e187-e194. doi: 10.1016/j.wombi.2022.07.001. Epub 2022 Jul 20.
All women require access to quality maternity care. Continuity of midwifery care can enhance women's experiences of childbearing and is associated with positive outcomes for women and infants. Much research on these models has been conducted with women with uncomplicated pregnancies; less is known about outcomes for women with complexities.
To explore the outcomes and experiences for women with complex pregnancies receiving midwifery continuity of care in Australia.
This integrative review used Whittemore and Knafl's approach. Authors searched five electronic databases (PubMed/MEDLINE, EMBASE, CINAHL, Scopus, and MAG Online) and assessed the quality of relevant studies using the Critical Appraisal Skills Programme (CASP) appraisal tools.
Fourteen studies including women with different levels of obstetric risk were identified. However, only three reported outcomes separately for women categorised as either moderate or high risk. Perinatal outcomes reported included mode of birth, intervention rates, blood loss, perineal trauma, preterm birth, admission to special care and breastfeeding rates. Findings were synthesised into three themes: 'Contributing to safe processes and outcomes', 'Building relational trust', and 'Collaborating and communicating'. This review demonstrated that women with complexities in midwifery continuity of care models had positive experiences and outcomes, consistent with findings about low risk women.
The nascency of the research on midwifery continuity of care for women with complex pregnancies in Australia is limited, reflecting the relative dearth of these models in practice.
Despite favourable findings, further research on outcomes for women of all risk is needed to support the expansion of midwifery continuity of care.
所有女性都需要获得高质量的孕产护理。助产护理的连续性可以提升女性的生育体验，并与对女性和婴儿的积极结果相关。关于这些模式的许多研究是针对怀孕情况正常的女性进行的；对于情况复杂的女性的结果了解较少。
探讨在澳大利亚接受助产连续性护理的怀孕情况复杂的女性的结果和体验。
本整合性综述采用了惠特莫尔和克纳夫的方法。作者检索了五个电子数据库（PubMed/MEDLINE、EMBASE、CINAHL、Scopus和MAG Online），并使用批判性评估技能计划（CASP）评估工具评估相关研究的质量。
确定了14项包括不同产科风险水平女性的研究。然而，只有三项分别报告了被归类为中度或高危女性的结果。报告的围产期结果包括分娩方式、干预率、失血量、会阴创伤、早产、入住特殊护理病房情况和母乳喂养率。结果被综合为三个主题：“促成安全的过程和结果”、“建立关系信任”以及“协作与沟通”。本综述表明，在助产连续性护理模式中情况复杂的女性有积极的体验和结果，这与低风险女性的研究结果一致。
澳大利亚针对怀孕情况复杂的女性的助产连续性护理研究尚处于起步阶段，这反映出这些模式在实践中相对较少。
尽管有积极的研究结果，但仍需要对所有风险女性的结果进行进一步研究，以支持扩大助产连续性护理。
