de Wolff Mie Gaarskjaer, Grylka-Baeschlin Susanne, Mueller Antonia Ν, Bodin Maja, Pagh Nanna Β, Ängeby Karin
Department of Obstetrics and Gynocology, Copenhagen University Hospital, Hvidovre, Denmark.
Research Institute of Midwifery and Reproductive Health, School of Health Sciences, ZHAW Zürich University of Applied Sciences, Winterthur, Switzerland.
Eur J Midwifery. 2025 Jul 10;9. doi: 10.18332/ejm/206921. eCollection 2025.
Early labor is critical in shaping birth experiences, and women seek midwifery care to manage challenges during this stage. A salutogenic attitude, focusing on positive experiences and health promotion, is needed instead of the current pathogenic maternity model. This study aimed to understand how midwives support women's positive early labor experience and to identify key elements contributing to salutogenic midwifery care practices during early labor.
We employed a qualitative study design, conducting nine focus group discussions (FGDs) with 39 women in Denmark, Sweden, and Switzerland. First, data were analyzed thematically using an inductive approach to capture codes. Second, a salutogenic best-fit framework guided the analysis, structuring the data into three domains: comprehensibility, manageability, and meaningfulness. Within domains, sub-themes were identified to elucidate how midwifery care might contribute to positive early labor experiences.
Comprehensibility was achieved when women trusted midwives to provide accessible, high-quality care tailored to individual needs to help them comprehend the maternity system. Manageability was experienced when midwives guided women through the uncertainties of early labor and provided plans when needed. Meaningfulness was created through availability, accessibility, and emotional support. Continuity of care was an underlying foundation for a positive experience of all three domains.
A salutogenic midwifery approach, centering on flexibility and individualization, was essential to women's positive experiences cross-nationally. Salutogenic midwifery care during early labor reduced anxiety and enhanced emotional resilience. Our findings underscore the importance of salutogenic midwifery care for women in early labor, which should be recognized and implemented in maternity care settings.
早期分娩对塑造分娩体验至关重要，女性会寻求助产护理来应对这一阶段的挑战。需要一种注重积极体验和健康促进的健康生成态度，而非当前的致病孕产妇模式。本研究旨在了解助产士如何支持女性获得积极的早期分娩体验，并确定有助于早期分娩期间健康生成助产护理实践的关键要素。
我们采用定性研究设计，在丹麦、瑞典和瑞士与39名女性进行了9次焦点小组讨论（FGD）。首先，使用归纳法对数据进行主题分析以获取编码。其次，一个健康生成最佳拟合框架指导分析，将数据构建为三个领域：可理解性、可管理性和有意义性。在各领域内，确定了子主题以阐明助产护理如何有助于获得积极的早期分娩体验。
当女性信任助产士能提供符合个人需求的可及、高质量护理以帮助她们理解孕产妇系统时，实现了可理解性。当助产士引导女性度过早期分娩的不确定性并在需要时提供计划时，体验到了可管理性。通过可及性、可获得性和情感支持创造了有意义性。连续护理是所有三个领域积极体验的潜在基础。
以灵活性和个性化为核心的健康生成助产方法对各国女性的积极体验至关重要。早期分娩期间的健康生成助产护理减少了焦虑并增强了情绪恢复力。我们的研究结果强调了健康生成助产护理对早期分娩女性的重要性，应在孕产妇护理环境中得到认可和实施。
