Tan Jia-Yi, Zhou Lin, Shi Li-Jia, Sun Qian, Wu Kai-Yi, Shen Yang, Zhang Jing
School of Public Health and Nursing, Hangzhou Normal University, No. 2318, Yu Hang Tang St, Cang Qian Area, Yu Hang Dis, Hangzhou, Zhejiang, China.
Department of Nursing, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China.
BMC Pregnancy Childbirth. 2025 Aug 25;25(1):882. doi: 10.1186/s12884-025-07973-7.
Against the backdrop of changes in the medical model, a clearer awareness among women of their rights, and a deeper emphasis on the "woman-centred" approach, it has become increasingly important to focus on the current state and quality of intrapartum interactions. While midwife-woman interactions during vaginal childbirth are recognized as central to shaping maternal health outcomes and birthing experiences, existing studies offer fragmented insights, with a limited synthesis of how these dynamics influence intrapartum care and support, maternal autonomy in decision-making, and the midwife-woman relationship.
To synthesize the existing literature addressing midwife-woman interactions during childbirth and to identify any research gaps.
A scoping review was conducted using Arksey and O'Malley's methodology, with results reported following the PRISMA-ScR guidelines. A three-stage search strategy was conducted between December 2023 and August 2024, and 11 databases were searched. Eligible articles were charted and thematically analyzed.
A total of 6,560 articles were retrieved, of which 22 were included in the review. Three themes and six subthemes were identified: "Directive or instructive communication", "Multi-facet support needs and provisions (Emotional support: The indispensable but unseen labour; Information support: how much to share; Professional support: Balancing Care and Protocols; Shared Decision-making: Navigating Autonomy and Challenges)", and "Close or distant intrapartum relationship (Trust and respect: The hidden pillars of intrapartum care; The shocking reality of obstetric violence)".
The study of midwife-woman intrapartum interaction needs further in-depth exploration. Notable discrepancies exist in the descriptions of intrapartum interactions between midwives and women, which may result in a mismatch between the care provided by the midwife and the actual needs of the woman. As an innovative and valuable approach, it is recommended that micro-analysis methods, such as CA, be employed in future research to gain a deeper understanding of the nuanced dynamics present in midwife-woman interactions during labour and birth.
The research protocol was preregistered on the Open Science Framework (Registration DOI: https://doi.org/10.17605/OSF.IO/R5WYQ ).
在医学模式转变、女性权利意识日益增强以及更加强调“以女性为中心”的方法这一背景下，关注分娩期互动的现状和质量变得越来越重要。虽然阴道分娩期间助产士与产妇的互动被认为是塑造孕产妇健康结局和分娩体验的核心，但现有研究提供的见解零散，对于这些动态如何影响分娩期护理与支持、产妇决策自主权以及助产士与产妇关系的综合研究有限。
综合现有关于分娩期间助产士与产妇互动的文献，并确定任何研究空白。
采用阿克西和奥马利的方法进行范围综述，并按照PRISMA-ScR指南报告结果。在2023年12月至2024年8月期间实施了三阶段搜索策略，检索了11个数据库。对符合条件的文章进行制表并进行主题分析。
共检索到6560篇文章，其中22篇纳入综述。确定了三个主题和六个子主题：“指导性或教育性沟通”、“多方面支持需求与提供（情感支持：不可或缺却无形的劳作；信息支持：分享多少；专业支持：平衡护理与规程；共同决策：把握自主权与挑战）”以及“分娩期关系的亲近或疏远（信任与尊重：分娩期护理的隐藏支柱；产科暴力的惊人现实）”。
助产士与产妇分娩期互动的研究需要进一步深入探索。助产士与产妇分娩期互动的描述存在显著差异，这可能导致助产士提供的护理与产妇实际需求不匹配。作为一种创新且有价值的方法，建议在未来研究中采用诸如会话分析等微观分析方法，以更深入地了解分娩和生产期间助产士与产妇互动中存在的细微动态。
该研究方案已在开放科学框架上预先注册（注册DOI：https://doi.org/10.17605/OSF.IO/R5WYQ ）
