Fatma Zuhaira Husna, Alvesson Helle Mölsted, Namazzi Gertrude, Kyobe Josephine Babirye, Ayebare Elizabeth
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Department of Health Policy Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.
BMC Pregnancy Childbirth. 2025 May 13;25(1):564. doi: 10.1186/s12884-025-07657-2.
Despite the well-documented benefits of upright positions and mobility during labour and childbirth, the adoption of these remains limited. Offering women choices in labour positions is essential for respectful maternity care. Since midwives play a pivotal role in guiding women through labour, their perspectives are crucial to the effective integration of these practices.
The study aimed to understand midwives' perspectives and reasoning behind their choice of labour positions.
This qualitative study was conducted in a regional referral hospital in eastern Uganda. Twelve midwives were recruited purposively at two different time points in December 2020 and February 2024. A data-driven reflexive thematic analysis was conducted.
Midwives' choice of labour positions was based on their understanding of the advantages and disadvantages for mothers and babies. Midwives were only open to changing their practices when they were confident in their knowledge and skills. The availability of resources influenced their perspectives on which positions were most feasible and effective in different situations. The midwives prioritised assessment of the mother's clinical condition rather than her preferences when choosing birth positions.
This study highlighted midwives' willingness to support different and, to them, new labour positions when confident in their efficacy and safety. Addressing misconceptions about risks and equipment needs is therefore crucial. The prevailing provider-centric norms in hospitals may shape midwives' approach to care, highlighting the need for supportive environments to foster midwives' confidence in new practices.
尽管分娩期间采用直立姿势和活动的诸多益处已有充分记录，但这些做法的采用情况仍然有限。为产妇提供分娩姿势的选择对于尊重产妇护理至关重要。由于助产士在指导产妇分娩过程中起着关键作用，他们的观点对于有效整合这些做法至关重要。
本研究旨在了解助产士对分娩姿势选择的观点及背后的原因。
这项定性研究在乌干达东部的一家地区转诊医院进行。2020年12月和2024年2月在两个不同时间点有目的地招募了12名助产士。进行了数据驱动的反思性主题分析。
助产士对分娩姿势的选择基于他们对母婴利弊的理解。助产士只有在对自己的知识和技能有信心时才愿意改变做法。资源的可用性影响了他们对不同情况下哪些姿势最可行和有效的看法。助产士在选择分娩姿势时优先考虑对母亲临床状况的评估而不是她的偏好。
本研究强调，当助产士对不同的、对他们来说是新的分娩姿势的有效性和安全性有信心时，他们愿意支持这些姿势。因此，消除对风险和设备需求的误解至关重要。医院中普遍存在的以提供者为中心的规范可能会影响助产士的护理方式，这凸显了营造支持性环境以增强助产士对新做法信心的必要性。
