Lopes Marlene I, Vieira Margarida, Cardoso Alexandrina
Health Sciences Research Unit, Nursing School of Coimbra, Coimbra, Portugal.
Universidade Católica Portuguesa, Centre for Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, Porto, Portugal.
Eur J Midwifery. 2025 Jul 29;9. doi: 10.18332/ejm/205673. eCollection 2025.
Allowing freedom of movement and positions during labor facilitates safe progression, improves maternal and neonatal outcomes, and contributes to a positive birth experience for women and their partners. Childbirth preparation aims to empower women by equipping them with skills and confidence to manage labor actively and knowledgeably. However, in many hospital settings, women's mobility remains restricted. This study explores expert perspectives on the core components of an intervention designed to promote women's autonomy and active participation during labor, to be implemented by nurse-midwives within Childbirth Preparation Programs in primary healthcare.
A qualitative study was conducted in February 2024 in Portugal, using a focus group composed of ten nurse-midwives recognized as experts in childbirth preparation. The session was recorded and analyzed through content analysis, guided by the Theory of Emancipated Decision-Making in Women's Healthcare.
Nine women and one man participated, aged 34-64 years, representing primary healthcare, hospitals, and academia. Six key themes emerged from the analysis: the intentionality behind the intervention; understanding the meanings and expectations women hold about their birth experience; empowering women by providing knowledge and skills; raising awareness of social norms that may influence women's decisions and actions; encouraging women to reflect on their options; and fostering woman-centered care.
The experts emphasized the importance of promoting mobility during labor to enhance perinatal outcomes and the childbirth experience. Empowering women through experiential learning, fostering reflection, supporting informed choices, and ensuring continuity of care through collaborative professional practices were identified as essential strategies for effective intervention.
分娩过程中允许自由活动和变换姿势有助于安全分娩，改善孕产妇和新生儿结局，并为产妇及其伴侣带来积极的分娩体验。分娩准备旨在通过使女性具备积极且明智地应对分娩的技能和信心来增强其能力。然而，在许多医院环境中，女性的活动仍然受到限制。本研究探讨了专家对于一项干预措施核心组成部分的观点，该干预措施旨在促进女性在分娩期间的自主性和积极参与，由初级医疗保健机构分娩准备项目中的助产士实施。
2024年2月在葡萄牙进行了一项定性研究，采用了由十位被公认为分娩准备专家的助产士组成的焦点小组。会议进行了记录，并在女性医疗保健中的解放性决策理论的指导下通过内容分析进行了分析。
九名女性和一名男性参与，年龄在34 - 64岁之间，代表初级医疗保健、医院和学术界。分析得出六个关键主题：干预背后的意图；理解女性对其分娩经历的意义和期望；通过提供知识和技能增强女性能力；提高对可能影响女性决策和行动的社会规范的认识；鼓励女性思考其选择；以及促进以女性为中心的护理。
专家们强调了在分娩期间促进活动以改善围产期结局和分娩体验的重要性。通过体验式学习增强女性能力、促进反思、支持明智选择以及通过协作性专业实践确保护理的连续性被确定为有效干预的关键策略。
