Abdul Hamid Alhassan Ramatu, Baumann Sara, Fapohounda Abimola, Tiah Janet Awopole Yepakeh, Laari Timothy Tienbia, Narbey Lauren, Niemczyk Nancy A, Bam Victoria, Anto-Ocrah Martina
University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.
United States Agency for International Development, Accra, Ghana.
Birth. 2024 Dec 9. doi: 10.1111/birt.12894.
BACKGROUND/INTRODUCTION: Midwives provide skilled, primary, reproductive, and sexual health care to women, adolescent girls, and infants throughout the perinatal period, promoting health and safeguarding against obstetric emergencies and maternal and infant mortality. In many cultures, midwifery has been a predominantly female profession. However, in emerging research, the proportion of male midwives is growing to augment shortages of female midwives, prompting a need for further research that explores the contributions of male midwives in maternal and child health. The objective of this scoping review was to synthesize key findings from the literature regarding the growing, global workforce of male midwives. Specifically, we aimed to evaluate (1) the temporal nature of the publications, (2) the geographic distributions of the emerging literature, and (3) the key findings regarding male midwives' training and work experiences.
We used Semantic Scholar and Google Scholar to identify relevant, peer-reviewed articles using the keywords "gender," "male," "men," "midwifery," and "nurse midwives," that met the inclusion criteria: (1) primary research papers, (2) published in the English language (for ease of understanding by the multinational, interdisciplinary authorship team), (3) explored male midwives' experiences during training/education and working, and (4) published between 2000 and 2023. Papers were excluded if they exclusively focused on females or nurses or other health professionals.
Our initial search yielded 57 articles, with an additional nine obtained by reviewing the references. After excluding duplicates and reviewing based on inclusion criteria, 26 papers were included in the scoping review. All 26 articles were published between 2011 and 2023, with the majority (65%, n = 17) of articles focused on populations in the African region (Aims 1 and 2). Key findings (Aim 3) were as follows: 1. Training experiences of male midwives: Compared to other regions, male midwifery students in African, Middle Eastern, and Asian settings reported challenging training conditions, possibly influenced by sociocultural factors and gendered expectations of men in these settings. 2. Pregnant/birthing persons' delivery experiences and gendered preferences for their attending midwife: A significant number of birthing persons would choose female midwives over male midwives for their care, despite acknowledging similar skill sets. However, younger clients, urban residents, and non-traditional men expressed a need for gender equity and greater acceptance of men as midwifery professionals. 3. Professional work environment: Many of the male midwives faced professional challenges, often stemming from societal and professional prejudices, leading to feelings of alienation and marginalization within the midwifery profession. Despite these challenges, they remained dedicated to the profession and felt supported by their family, friends, and coworkers.
Male midwives represent a growing proportion of the global obstetric workforce and provide an important contribution to addressing maternal morbidity and mortality. Further attention to providing equitable training opportunities, navigating caregiving within settings with strong cultural and religious influences, integrating cultural, geographic, and religious diversity into the midwifery curriculum, and providing male midwives with mentorship and role model support to grow and sustain their careers are urgently needed for improving maternal and infant health outcomes.
背景/引言:在围产期,助产士为女性、少女和婴儿提供专业的初级生殖和性健康护理,促进健康并预防产科急症以及母婴死亡。在许多文化中,助产工作一直主要由女性从事。然而,在新出现的研究中,男助产士的比例不断增加,以弥补女助产士的短缺,这促使有必要开展进一步研究,探讨男助产士在母婴健康方面的贡献。本范围综述的目的是综合文献中关于全球不断壮大的男助产士队伍的主要发现。具体而言,我们旨在评估:(1)出版物的时间特征;(2)新兴文献的地理分布;(3)关于男助产士培训和工作经历的主要发现。
我们使用语义学者和谷歌学术搜索引擎,通过关键词“性别”“男性”“男性群体”“助产”和“助产护士”来识别相关的同行评议文章,这些文章需符合纳入标准:(1)原创研究论文;(2)以英语发表(以便跨国、跨学科的作者团队理解);(3)探讨男助产士在培训/教育和工作期间的经历;(4)发表于2000年至2023年之间。如果文章仅专注于女性、护士或其他卫生专业人员,则予以排除。
我们最初的搜索产生了57篇文章,通过查阅参考文献又获得了9篇。在排除重复文章并根据纳入标准进行筛选后,有26篇文章被纳入范围综述。所有26篇文章均发表于2011年至2023年之间,其中大多数文章(65%,n = 17)关注非洲地区的人群(目标1和2)。主要发现(目标3)如下:1. 男助产士的培训经历:与其他地区相比,非洲、中东和亚洲地区的男助产专业学生报告称培训条件具有挑战性,这可能受到社会文化因素以及这些地区对男性的性别期望的影响。2. 孕妇/产妇的分娩经历以及对助产士性别的偏好:尽管承认技能相当,但相当数量的产妇在接受护理时会选择女助产士而非男助产士。然而,年轻客户、城市居民和非传统男性表示需要性别平等,并更能接受男性作为助产专业人员。3. 职业工作环境:许多男助产士面临职业挑战,这些挑战往往源于社会和职业偏见,导致他们在助产行业中感到疏离和边缘化。尽管面临这些挑战,他们仍致力于该职业,并感到得到家人、朋友和同事的支持。
男助产士在全球产科劳动力中所占比例不断增加,为解决孕产妇发病率和死亡率做出了重要贡献。迫切需要进一步关注提供公平的培训机会,在具有强大文化和宗教影响的环境中开展护理工作,将文化、地理和宗教多样性纳入助产课程,并为男助产士提供指导和榜样支持,以促进其职业发展并维持其职业生涯,从而改善母婴健康结果。