Facilitators and barriers in the humanization of childbirth practice in Japan
Facilitators and barriers in the humanization of childbirth practice in Japan
复制标题
DOI：
10.1186/1471-2393-10-25
复制
发表时间：
2010-05-27
影响因子：
3.1
通讯作者：
Misago, Chizuru
中科院分区：
文献类型：
--
作者：
Behruzi, Roxana;Hatem, Marie;Misago, Chizuru
背景：人性化分娩意味着在分娩过程中考虑妇女的价值观、信仰和感受，尊重她们的尊严和自主权。减少过度医疗分娩、赋予妇女权力以及采用循证孕产实践是促进人性化分娩的策略。然而，出生地及其社会文化价值观和有关生育的信仰可能会深刻影响生育实践。本研究旨在探讨日本在不同分娩环境中的分娩经验，其中人性化分娩已被确定为相关机构的优先目标，并探讨这些中心在实施人性化分娩过程中遇到的障碍和促进因素。 方法：本研究采用了定性实地研究设计。招募了 44 个人和 9 个机构。通过观察、现场记录、焦点小组、非正式和半结构化访谈收集数据。进行了定性内容分析。结果：所有机构都实施了旨在减少剖腹产并尽可能保持自然分娩的策略。人性化分娩实践中遇到的障碍和促进因素主要分为四类：规则和策略、身体结构、偶然因素和个人因素。在人性化分娩护理中发现的最重要的障碍是限制分娩伴侣在场的制度规则和策略。主要促进因素是妇女自身的文化价值观和对自然分娩的信仰，以及旨在防止不必要的医疗干预的制度策略。结论：日本分娩机构将实施人性化分娩作为其使命的一部分，总体而言，在改善护理方面取得了成功。然而，实现最终目标仍然存在障碍。重要的是，日本女性对于自然分娩的文化价值观和信仰是促进日本分娩人性化的重要因素。
Background: Humanizing birth means considering women's values, beliefs, and feelings and respecting their dignity and autonomy during the birthing process. Reducing over-medicalized childbirths, empowering women and the use of evidence-based maternity practice are strategies that promote humanized birth. Nevertheless, the territory of birth and its socio-cultural values and beliefs concerning child bearing can deeply affect birthing practices. The present study aims to explore the Japanese child birthing experience in different birth settings where the humanization of childbirth has been indentified among the priority goals of the institutions concerned, and also to explore the obstacles and facilitators encountered in the practice of humanized birth in those centres.Methods: A qualitative field research design was used in this study. Forty four individuals and nine institutions were recruited. Data was collected through observation, field notes, focus groups, informal and semi-structured interviews. A qualitative content analysis was performed.Results: All the settings had implemented strategies aimed at reducing caesarean sections, and keeping childbirth as natural as possible. The barriers and facilitators encountered in the practice of humanized birth were categorized into four main groups: rules and strategies, physical structure, contingency factors, and individual factors. The most important barriers identified in humanized birth care were the institutional rules and strategies that restricted the presence of a birth companion. The main facilitators were women's own cultural values and beliefs in a natural birth, and institutional strategies designed to prevent unnecessary medical interventions.Conclusions: The Japanese birthing institutions which have identified as part of their mission to instate humanized birth have, as a whole, been successful in improving care. However, barriers remain to achieving the ultimate goal. Importantly, the cultural values and beliefs of Japanese women regarding natural birth is an important factor promoting the humanization of childbirth in Japan.