Maimbolwa M C, Ransjö-Arvidson A B, Ng'andu N, Sikazwe N, Diwan V K
Lusaka School of Nursing, Zambia.
Midwifery. 1997 Sep;13(3):125-31. doi: 10.1016/s0266-6138(97)90002-4.
To describe the routine care of women during normal labour and delivery, and the immediate care of newborn babies in Zambia at different levels of health care.
A descriptive survey carried out between July 1994 and January 1995.
Eleven maternity facilities, one University teaching hospital, two urban health centres and eight rural hospitals in one province in Zambia.
Eighty-four women in normal childbirth and their babies studied from admission to the labour ward until time of discharge from the labour ward.
Observations related to the care of the women during normal labour and delivery, and the immediate care of the baby. The findings show that women were confined to bed during the whole labour and delivery period, food and drinks were withheld, and no gowns were provided. None of the women were allowed to have a companion present during labour. Fetal monitoring was inconsistent and the partograph was either not used or partly lacking. All women were delivered in a lithotomy position and primiparae were fixed in stirrups during the second and third stages of labour. There was general lack of support for early mother/baby contact, prevention of hypothermia in the babies and early initiation of breast feeding.
Based on our findings we suggest that many present maternity ward routines, both physiological and psychological, should be carefully studied. It is also suggested that the midwives reorient their caring practices to more culturally and evidenced-based maternity care. Refresher courses for midwives who have been working for many years are recommended.
描述赞比亚不同医疗保健水平下正常分娩妇女的常规护理以及新生儿的即时护理情况。
1994年7月至1995年1月期间开展的一项描述性调查。
赞比亚一个省份的11个产科设施，其中包括1所大学教学医院、2个城市健康中心和8所农村医院。
84名正常分娩的妇女及其婴儿，从入院待产病房直至出院期间接受研究。
观察正常分娩和接生过程中对妇女的护理以及对婴儿的即时护理情况。结果显示，妇女在整个分娩期都被限制在床上，禁食禁水，且未提供病号服。分娩期间没有一名妇女被允许有陪伴人员在场。胎儿监测不连贯，产程图要么未使用，要么部分缺失。所有妇女均以截石位分娩，初产妇在第二和第三产程被固定在脚蹬上。普遍缺乏对母婴早期接触、预防婴儿体温过低以及尽早开始母乳喂养的支持。
基于我们的研究结果，我们建议应仔细研究当前产科病房在生理和心理方面的许多常规做法。还建议助产士将其护理方式重新定位为更具文化性和循证性的产科护理。建议为从业多年的助产士提供进修课程。
