Armour Susanne, Keedle Hazel, Gilkison Andrea, Dahlen Hannah Grace
School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith NSW 2751, Australia.
School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith NSW 2751, Australia.
Sex Reprod Healthc. 2023 Sep;37:100889. doi: 10.1016/j.srhc.2023.100889. Epub 2023 Jul 14.
Midwives provide reproductive healthcare to women, including during termination of pregnancy (TOP) after 12 weeks (late TOP). Their expertise, knowledge and woman-centred care approach sees them ideally placed for this role. However, the medical, social and emotional complexities of late TOP can cause midwives significant distress. An integrative review methodology was used to examine the research on midwifery care for late TOP and identify support strategies and interventions available to midwives in this role. Five databases and reference lists were searched for relevant studies published between 2000 and 2021. A total of 2545 records were identified and 24 research studies included. Synthesis of research findings resulted in three themes: Positive aspects, negative aspects and carers need care. Midwives reported a high level of job satisfaction when caring for women during late TOP. Learning new skills and overcoming challenges were positive aspects of their work. Yet, midwives felt unprepared to deal with challenging aspects of late TOP care such as the grief and the psychological burden of the role. Caring for the baby with dignity had both positive and negative aspects. Midwives relied predominantly on close colleagues for help and debriefing as they felt poorly supported by management, judged by co-workers and lacked appropriate support to reduce the emotional effects of late TOP care. Midwives need support, although current evidence has not identified the most appropriate and effective strategy to support them in this role.
助产士为女性提供生殖保健服务，包括在妊娠12周后终止妊娠（晚期终止妊娠）期间。她们的专业知识、技能以及以女性为中心的护理方法使她们非常适合这一角色。然而，晚期终止妊娠在医学、社会和情感方面的复杂性可能会给助产士带来极大的困扰。本研究采用综合综述方法，审视关于晚期终止妊娠助产护理的研究，并确定可供担任这一角色的助产士使用的支持策略和干预措施。检索了五个数据库及参考文献列表，以查找2000年至2021年间发表的相关研究。共识别出2545条记录，纳入了24项研究。研究结果综合为三个主题：积极方面、消极方面以及护理人员需要关怀。助产士报告称，在晚期终止妊娠期间照顾女性时，工作满意度较高。学习新技能和克服挑战是她们工作的积极方面。然而，助产士觉得自己没有准备好应对晚期终止妊娠护理中具有挑战性的方面，比如悲伤情绪和该角色带来的心理负担。体面地照顾婴儿既有积极方面，也有消极方面。助产士主要依靠亲密同事提供帮助和进行汇报交流，因为她们感觉管理层支持不足，受到同事评判，且缺乏适当支持来减轻晚期终止妊娠护理带来的情感影响。助产士需要支持，尽管目前的证据尚未确定在此角色中支持她们的最适当和有效的策略。
