Obstetric Unit, Antrim Area Hospital, Antrim, Northern Ireland, UK.
School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK.
Birth. 2023 Dec;50(4):711-734. doi: 10.1111/birt.12759. Epub 2023 Aug 21.
Women's birth experiences can range from positive and satisfying to negative and traumatizing. Midwives caring for women can also be exposed to these traumatic childbirth experiences. There is a paucity of research on the impact these experiences have on midwives and their practice. The PEO framework guided the research review question.
Seven electronic databases were systematically searched. The quality of each included study was assessed using the tool appropriate to the study's methodological approach; Critical Appraisal Skills Program (CASP) criteria and the Mixed Methods Appraisal Tool (MMAT) Version 2018. The Consolidated Criteria for Reporting Qualitative Research (COREQ) tool was utilized to assess reported findings. Confidence in the Evidence from Reviews of Qualitative research (CERQual) was used to grade the confidence in the evidence of the qualitative research. Data were thematically analyzed to formalize the identification and development of themes.
A total of 12 studies were included. Synthesis of the evidence generated one overarching theme, "Midwives, the forgotten victims", and three themes describing the essences of midwives' experiences: "Bruised and battered but still smiling"; "Wearing armour to protect my soul"; "Members of my team are holding me up, others are pulling me down".
Midwives expressed feelings of shock, fear, responsibility, and powerlessness which may contribute to some experiencing serious mental illness. They reported a shaken belief in the normal physiologic birth process which consequently led to more defensive practice. Research is needed to identify high-quality interventions to support midwives after these events. This systematic review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO; Registration CRD42021252033).
女性的分娩经历可以从积极和满意到消极和创伤。照顾女性的助产士也可能会经历这些创伤性分娩经历。关于这些经历对助产士及其实践的影响的研究很少。PEO 框架指导了研究综述问题。
系统地搜索了七个电子数据库。使用适合研究方法学方法的工具评估每个纳入研究的质量；批判性评估技能计划 (CASP) 标准和混合方法评估工具 (MMAT) 版本 2018。使用综合定性研究报告标准 (COREQ) 工具评估报告的发现。使用从定性研究中审查证据的信心 (CERQual) 来评估定性研究证据的置信度。对数据进行主题分析，以正式确定和发展主题。
共纳入 12 项研究。证据综合产生了一个总体主题，“助产士，被遗忘的受害者”，以及三个描述助产士经历本质的主题：“瘀伤累累，但仍微笑”；“穿着盔甲保护我的灵魂”；“我的团队成员支撑着我，其他人则把我拉下来”。
助产士表示感到震惊、恐惧、责任和无助，这可能导致一些人患有严重的精神疾病。他们报告说，对正常生理分娩过程的信念受到动摇，这反过来又导致了更具防御性的实践。需要研究确定高质量的干预措施，以在这些事件发生后为助产士提供支持。本系统评价方案已在国际前瞻性系统评价登记处（PROSPERO；注册 CRD42021252033）注册。
