Abortion-related care and the role of the midwife: a global perspective
Abortion-related care and the role of the midwife: a global perspective
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DOI：
10.2147/ijwh.s178601
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发表时间：
2018-01-01
影响因子：
2.3
通讯作者：
Dowler, Melanie
中科院分区：
文献类型：
--
作者：
Fullerton, Judith;Butler, Michelle M.;Dowler, Melanie
简介：国际助产士联合会（ICM）代表113个国家的132个助产协会。ICM传播基本助产实践（EC）的基本能力，描述助产实践的全球范围。2010年首次描述了助产士在提供堕胎相关护理服务方面的基本（核心）和扩大（额外或可选）作用。对获得堕胎服务特别关键的三个项目进行了文献审查。2016年出现的研究结果。-2017年关于这三项的最新研究。方法：采用改进的德尔菲法，通过互联网进行三轮研究。提出了37项与堕胎有关的知识和技能陈述。结果：共有895人参与。调查进行时，这三轮的受访者总数代表了105个成员国中的90个。助产士在提供全面的流产护理，包括流产转诊和流产后计划生育方面的作用达到了85%的共识，被指定为全球范围内助产实践的必要（基本）知识或技能。对于希望提供这些服务的助产士来说，提供药物流产和手动真空抽吸流产是可选的。非洲法语和英语区域、亚太国家和经济发展水平较低的国家对后一种做法的赞同程度最高。结论：在最近的德尔菲研究中，助产士在提供堕胎相关护理服务中的作用得到了重申，以告知EC的更新。助产士作为医疗和真空抽吸堕胎的直接提供者的作用得到重申，对于那些希望在法律授权的司法管辖区获得提供这些服务的必要能力的个人助产士。
Introduction: The International Confederation of Midwives (ICM) represents 132 midwifery associations in 113 countries. The ICM disseminates the Essential Competencies for Basic Midwifery Practice (EC) that describes the global scope of midwifery practice. The basic (core ) and expanded (additional or optional) role of midwives in providing abortion-related care services was first described in 2010. A literature review about three items that are particularly critical to access to abortion services was conducted. Findings that emerged in the recent 2016.-2017 update study about these three items are presented.Methods: A modified Delphi study was administered via the Internet in a series of three rounds. Thirty-seven statements of abortion-related knowledge and skill were presented.Results: A total of 895 individuals participated. The total of respondents across all three rounds represented 90 of the 105 member countries at the time of the study. The role of midwives in providing comprehensive abortion care, including referral for abortion and provision of postabortion family planning, achieved the necessary 85% agreement to be designated as essential (basic) knowledge or skill for the global scope of midwifery practice. The provision of medication abortion and performance of manual vacuum aspiration abortion were designated as optional for midwives who wished to provide these services. Endorsement of these latter practices was highest in both Francophone and Anglophone regions of Africa, Asian Pacific countries, and countries at a lower state of economic development.Conclusion: The role of midwives in provision of abortion-related care services was reaffirmed in the recent Delphi study to inform the update to the EC. The role of midwives as direct providers of medical and vacuum aspiration abortions was reaffirmed for those individual midwives who wish to obtain the requisite competency to provide those services, in jurisdictions where these services are legally authorized.