Chinese midwifery: the history and modernity

Aim

to investigate how and why Chinese midwife numbers are dwindling, and to help understand the role of midwives in society in general.

Method

to critically examine Chinese midwifery in three stages: (1) historical literature overview; (2) identification and reinterpretation of Chinese midwifery and its development; (3) placing issues that have arisen within a sociological context (i.e. the modernisation of obstetric technologies and the meaning of modernity).

Findings

no books on the history of Chinese midwifery were found. History was classified into three stages: (1) before 1929, a period of an indigenous model; (2) 1929–1996, the highs and lows of the bio-medical model; (3) after 1996, the demise of Chinese midwives. The issues identified were the legitimacy and professionalisation of Chinese midwives, the meaning of modernity and the reasons for the decline of Chinese midwifery.

Conclusion

no sufficient evidence-based research was conducted to support the recent changes made to Chinese midwifery. The modernisation of maternity care in China took place amid dramatic social and cultural changes within society. As a consequence, midwifery as a profession in China has been marginalised. The modernisation of maternity care has failed to deliver on personal choice, quality of service and professional diversity.

Implications for practice

evidence-based research and the state's responsibility are essential to ensure the quality of maternity care and to protect the interests of women. The state's responsibilities include legislation regarding the role of midwives, code of practice, professional standards, responsibility and accountability in order to make midwifery care a true choice for women.     

CATCH: development of a home-based midwifery intervention to support young pregnant smokers to quit

Objective

to develop, implement and evaluate a supportive midwifery intervention, Community Action on Tobacco for Children's Health (CATCH), to help young pregnant smokers to quit.

Design

action research project funded from April 2002 to June 2005.

Setting and participants

CATCH was based in a single hospital maternity unit in the West of Scotland and targeted a deprived population of pregnant smokers aged 25 years and under. Outreach work was undertaken in the local community and cessation support was provided in women's own homes.

Intervention

CATCH aimed to meet the particular needs of young pregnant women through a tailored, non-judgmental approach. The service was distinctive as it employed a holistic approach to smoking cessation which focused not only on individual choices and motivations, but on the wider life circumstances that may preclude behaviour change.

Measures

internal and external teams collaborated to ensure a comprehensive evaluation, gathering of both process and outcome data. Outcomes (including self-reported and carbon monoxide validated quit status) were assessed by quantitative surveys undertaken at enrolment to the service and at 3- and 12-month follow-up. All those lost to follow-up were assumed to still be smoking. Participants’ views of the service were gathered independently by an external evaluation team, and a detailed qualitative case study, capturing ongoing learning, was undertaken. Data were collected from participants who joined the project over a 16-month period (November 2002–February 2004).

Findings

the study demonstrated a feasible approach to engaging young pregnant smokers to help them quit. Obstetricians and midwives were willing to refer to a service based in their maternity unit run by a specially trained midwife, and users reported a positive experience of the service. Of 152 eligible clients referred within the 16-month period, 79 (52%) joined CATCH. Of those who joined, 18 (22.8%) were self-reported non-smokers at 3 months, of whom 16 (20.3%) were validated as non-smokers using carbon monoxide monitoring. Thirteen (16.5%) clients reported being smoke free at 12 months, of whom 10 (12.7%) were validated as non-smokers at 12 months.

Implications for practice

CATCH suggests that close partnership with the multi-disciplinary maternity team and integration into the maternity system is invaluable for smoking cessation services targeting pregnant women. It points to the benefits of the service being delivered by a trained midwife in clients’ own homes. Flexibility and a non-judgmental approach are essential to engagement. Attention to the context and wider circumstances of clients’ lives and involving friends and family enables clients to focus on their own smoking.     

助产士的职业危害因素及预防探讨

目的：探讨助产士的职业相关危害因素和预防措施。方法：分析助产士可能接触到的职业危害因素和相关防护措施。结果：助产士接触到的职业危害因素主要包括物理、生物、化学及社会方面。具体防护措施包括：自我防护措施、接生时防护措施、加强锐器和消毒剂防护、分娩室环境防护及加强学习培训和心理干预等。结论：充分认识和了解导致助产士危害的物理、化学、生物、社会等方面的职业损害,才能在工作中加强管理和防护,提高自我保护意识,避免工作过程中不必要的职业损害,有助于提高助产工作质量和效果。     

滇西北助产士核心胜任力调查

目的调查滇西北地区助产士基本情况,评估助产士核心胜任力水平,分析影响因素,为少数民族地区助产专业教育及管理者提供政策制定和管理的参考依据。方法采用助产士核心胜任力量表对滇西北地区公立医院的83名助产士进行问卷调查。结果助产士核心胜任力总分为(3. 51±0. 47)分。各维度得分由高到低为产后保健、孕期保健、分娩保健、新生儿保健、孕前保健、公共卫生保健。助产士年龄、助产工龄、岗前培训时间与核心胜任力总分及各维度得分有相关性。不同医院等级、婚姻状况、专业背景、在职教育的助产士孕前保健得分比较差异有统计学意义(P<0. 05)。不同专业背景的助产士孕期保健得分比较差异有统计学意义(P<0. 05)。不同医院等级的助产士公共卫生保健得分比较差异有统计学意义(P<0. 05)。结论滇西北地区助产士核心胜任力整体水平较差。应适当提高助产士准入制度,并为在岗助产士提供相关培训,提高助产士核心胜任力。     

Midwives' and doulas' perspectives of the role of the doula in Australia: a qualitative study

Objective

to explore midwives’ and doulas’ perspectives of the role of the doula in Australia.

Background

doulas are relatively new in Australia; nevertheless, demand for them is increasing. Research has not previously explored the role of a doula in Australia. This research aimed to answer the question: What are midwives’ and doulas’ perspectives of the role of a doula in Australia?

Design

qualitative study using focus groups that were digitally recorded, transcribed and the data analysed using thematic analysis.

Setting

New South Wales, Australia.

Participants

11 midwives and six doulas.

Findings

the key theme that emerged was that ‘the broken maternity system’ is failing women and midwives. The system is preventing midwives from providing woman- centred care. As a result, doulas are ‘filling the gap’ and midwives feel that doulas are ‘taking our role’. Doulas fill the gap by providing continuity of care, advocating for women, protecting normal birth and by providing breast-feeding advice and emotional support in the community. Midwives are concerned that doulas are taking the caring part of their role from them and want the ‘broken’ maternity system fixed. Midwives described that doulas take their role from them by changing the relationship between themselves and labouring women, by reducing their role to obstetric nurses, by overstepping the doula role boundaries, and by holding the power at births.

Implications for practice

despite the conflict reported between midwives and doulas, both groups identified that they see the potential for future collaboration. Taking into account the continued employment of doulas, it is important to improve collaboration between midwives and doulas for the sake of childbearing women.     

站立式待产椅的设计及应用

目的 设计站立式待产椅,并评价其应用效果。方法 站立式待产椅由椅背、抓握部件、椅面、足部嵌槽等7个部分组成。2020年8月—12月,选取杭州市某三级甲等医院产科收住入院的临产后枕后位的100名产妇为研究对象,按随机数字表法分为试验组50名和对照组50名。试验组在助产士的指导下应用站立式待产椅纠正枕后位,对照组运用传统的待产体位变化（侧卧位+侧俯卧位）纠正枕后位,比较两组胎头位置纠正率、分娩方式及不良事件发生率。结果 试验组胎头位置纠正率为86%,高于对照组的56%,差异有统计学意义（P=0.001）。试验组自然分娩率为88%,高于对照组的66%;阴道助产率为4%,低于对照组的16%;剖宫产率为8%,低于对照组的18%,差异有统计学意义（P=0.009）。结论 站立式待产椅可有效纠正产妇枕后位,提高自然分娩率,是一种便利且安全的分娩辅助器械,可改善产妇的分娩体验。     

助产士参与创伤性分娩体验质性研究的Meta整合

目的系统评价助产士参与创伤性分娩体验的质性研究,为促进助产士心理健康及助产学科发展提供参考。方法计算机检索PubMed、CINAHL、Web of Science、Scopus、Embase、SinoMed、中国社会科学引文索引、中国知网、万方和维普数据库关于助产士参与创伤性分娩体验的质性研究,检索时限为建库至2020年12月。采用澳大利亚乔安娜布里格斯研究所质性研究质量评价标准进行文献质量评价,使用汇集性整合方法对结果进行整合。结果共纳入12篇研究,提炼出104个结果,归纳形成了10个类别,综合得出4个整合结果。整合结果1:分娩创伤事件对助产士造成严重的身心及职业影响;整合结果2:助产士会采取不同的策略来应对分娩创伤事件;整合结果3:助产实践中面临多重困境,影响助产士对分娩创伤事件的体验;整合结果4:参与创伤性分娩后,助产士渴望获得心理支持。结论分娩创伤事件会给助产士造成严重影响。助产士应正视负性情绪,学会积极应对;医疗机构应合理配置产科资源,缓解助产实践面临的困境;管理者应重视助产士参与创伤性分娩的体验,提供心理支持,促进助产士的身心健康。     

Effects of music medicine on premenstrual symptoms levels and quality of life: A randomized controlled trial

BackgroundPremenstrual syndrome is an important health problem affecting women of reproductive age. This study aimed to show that music medicine can be used to reduce the premenstrual syndrome levels and increase the quality of life of women.DesignA prospective, single-blinded randomized controlled trial.MaterialsThe study was conducted between January and April 2021 on 97 college students. The participants consisted of women over 20 years of age and suffering from premenstrual syndrome. The participants were randomized into music and control groups.ResultsImmediately post-intervention, the women in the experimental groups had significantly higher reduced premenstrual syndrome levels and an improved quality of life. Music and control groups were evaluated with The Premenstrual Syndrome Scale (PMSS) and the short form of the Short of World Health Organization quality of life questionnaire (WHOQOL‐BREF). Comparing these two groups, music significantly reduced the premenstrual syndrome level after application (PMSS-1123.23 ± 32.06 vs. 105.90 ± 27.55, respectively, PMSS-2 94.21 ± 28.42 vs. 119.44 ± 27.29, respectively, p < .05). Comparing the music medicine and control groups had significantly increased WHOQOL-BREF scores (Physical, psychological, and environmental) after the application (13.71 vs. 13.14; 14.33 vs. 15.44 vs.14.66, respectively, p < .05).ConclusionPremenstrual symptoms were significantly reduced in the music medicine group than the control group. Additionally, music medicine improves the quality of life.     

助产士核心胜任力量表在北京市助产士中的适用性研究

目的 评价助产士核心胜任力量表在北京市助产士中应用的信度和效度,探讨此量表的适用性.方法 采用助产士核心胜任力量表,对北京市32家医院的369名助产士进行测评,对量表进行信度和效度分析.结果 助产士核心胜任力量表有较好的内部一致性(Cronbach's α系数为0.950)和稳定性(重测信度为0.832).54个条目在提取的6个公因子中的分布与原量表结构基本一致,累积贡献达68.405％.量表能够区分不同特征助产士的核心胜任力水平,具有较好的判别效度.结论 助产士核心胜任力量表具有良好的信度和效度,适用于我国助产士核心胜任力的评价.但仍需多区域扩大样本进行量表的适用性评价,以推动量表的完善和推广应用.     

Midwifery,nursing and medical care on the high seas: An immigration voyage to colonial Australia 1848–1849

BackgroundThe lives of individuals are infinitely fascinating, especially when viewed at the intersection of their relationship with other people and their environment. Of interest in this article are the incidents of childbirth and the role of midwife and doctor in these crucial life events. Perhaps of greater significance is the story of those on board this one voyage of the Steadfast within the grand narrative of British immigration to Australia in the nineteenth century.AimThis article aims to demonstrate that it was the human cargo and their need of health care in the voyage of the Steadfast, which contributed to the historical narrative of immigration and quarantine, the prelude to life in the colonial environment.MethodThis is qualitative research using historical methodology involving the selection of available documents. The primary document sourced is that of the surgeon-superintendent’s journal on the Steadfast. The methodology used is narrative, recording the medical information as well as providing background context for the main characters for the purpose of situating them in the immigration story.FindingsHealth care, particularly maternity care, on immigration ships was limited. Birthing at sea was a dangerous process for an immigrant woman often resulting in her death, the death of her infant or both mother and child could perish. If disease occurred during the sea voyage, then quarantine of the ship and passengers was instigated on arrival at Sydney Harbour.DiscussionThis article draws on the journal notes of the surgeon superintendent which logs the health incidents of immigrants requiring midwifery, nursing and medical care on a sea voyage from London to the colony of New South Wales in the mid-nineteenth century. This article focuses on the maternity events and the necessity for quarantine measures to prevent the spread of infectious diseases in the colony of New South Wales.