Çankaya Seyhan, Tezgören Esra, Dikmen Hacer Alan
Faculty of Health Science, Midwifery Department, Selcuk University, Aladdin Keykubat Campus Selcuklu, Konya, Turkey.
Arch Gynecol Obstet. 2024 Dec;310(6):3009-3027. doi: 10.1007/s00404-024-07844-0. Epub 2024 Nov 27.
A woman's experiences of childbirth, which represents a significant transition in the journey towards motherhood, encompass a range of factors that can influence breastfeeding, parenting behaviors, and readiness for discharge. However, research exploring the intrapartum and postpartum care aspects of the WHO-developed intrapartum care model remains scarce, particularly with regard to breastfeeding, parenting behaviors, and the readiness of the mother in the early postpartum period.
The objective of this study was to examine the impact of the intrapartum care model that adheres to the guidelines set forth by the World Health Organization (WHO) on several key outcomes, including the mother's maternal behavior towards her infant postpartum, breastfeeding self-efficacy, the success of breastfeeding, and the mother's readiness for hospital discharge.
The study was a randomized controlled trial. The study was conducted with 128 primiparous pregnant women (intervention group n = 64, control group n = 64) admitted to the maternity unit of a training and research hospital in a province in the Central Anatolia region of Turkey. The pregnant women in the intervention group were provided with intrapartum care in accordance with the WHO recommendations following the achievement of cervical dilatation reaching 5 cm. The control group was provided with only standard intrapartum and postpartum care. The data were collected using a personal information form, a postpartum parenting behavior scale, a breastfeeding self-efficacy scale, a breastfeeding charting system and documentation tool (LATCH), and a hospital discharge readiness scale.
The mean scores for parenting behavior and breastfeeding self-efficacy of the women in the intervention group who received intrapartum care in accordance with the World Health Organization (WHO) recommendations were found to be significantly higher than those of the women in the control group (p < 0.001). Additionally, the mean LATCH score of the women in the intervention group (9.6 ± 0.8) was higher than that of the women in the control group (8.4 ± 1.6) and no breastfeeding problems were observed (p < 0.001). The women in the intervention group exhibited a higher level of readiness for hospital discharge (176.3 ± 10.7) compared to the women in the control group (149.6 ± 13.7). The mean score for the subscale "expected support" on the readiness for hospital discharge scale was found to be 9 ± 7.2 in the intervention group, which was considerably lower than the mean score of the control group (15.2 ± 8.4). It was determined that women in the intervention group who received the intrapartum care model required less support in the postpartum period compared to women in the control group (p < 0.001).
The intrapartum care model provided in line with WHO recommendations increases mothers' parenting behavior, breastfeeding self-efficacy, and breastfeeding success, and supports them to be more ready for discharge from the hospital.
分娩是女性迈向母亲角色过程中的一个重要转变，其经历包含一系列会影响母乳喂养、育儿行为及出院准备情况的因素。然而，探索世界卫生组织制定的产时护理模式中有关产时和产后护理方面的研究仍然匮乏，尤其是在母乳喂养、育儿行为以及产后早期母亲的准备情况方面。
本研究的目的是检验遵循世界卫生组织（WHO）制定的指南的产时护理模式对几个关键结果的影响，包括母亲产后对婴儿的母性行为、母乳喂养自我效能感、母乳喂养的成功率以及母亲的出院准备情况。
该研究为一项随机对照试验。研究对象为土耳其安纳托利亚中部地区某省一家培训与研究医院产科收治的128名初产妇（干预组n = 64，对照组n = 64）。干预组孕妇在宫颈扩张达5厘米后，按照WHO的建议接受产时护理。对照组仅接受标准的产时和产后护理。数据通过个人信息表、产后育儿行为量表、母乳喂养自我效能量表、母乳喂养记录系统及记录工具（LATCH）以及出院准备情况量表收集。
发现按照世界卫生组织（WHO）建议接受产时护理的干预组女性，其育儿行为和母乳喂养自我效能感的平均得分显著高于对照组女性（p < 0.001）。此外，干预组女性的平均LATCH得分（9.6 ± 0.8）高于对照组女性（8.4 ± 1.6），且未观察到母乳喂养问题（p < 0.001）。与对照组女性（149.6 ± 13.7）相比，干预组女性表现出更高的出院准备水平（176.3 ± 10.7）。在出院准备情况量表上，干预组“预期支持”子量表的平均得分为9 ± 7.2，显著低于对照组的平均得分（15.2 ± 8.4）。结果表明，与对照组女性相比，接受产时护理模式的干预组女性在产后所需的支持更少（p < 0.001）。
按照WHO建议提供的产时护理模式可提高母亲的育儿行为、母乳喂养自我效能感及母乳喂养成功率，并有助于她们更好地为出院做准备。
