Why do women assume a supine position when giving birth? The perceptions and experiences of postnatal mothers and nurse-midwives in Tanzania
Why do women assume a supine position when giving birth? The perceptions and experiences of postnatal mothers and nurse-midwives in Tanzania
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DOI：
10.1186/s12884-020-2726-4
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发表时间：
2020-01-13
影响因子：
3.1
通讯作者：
Eustace, Lucia
中科院分区：
文献类型：
--
作者：
Mselle, Lilian Teddy;Eustace, Lucia
背景在坦桑尼亚出现西医之前，妇女以直立姿势分娩，可以是坐着、蹲着或跪着。分娩时的妇女会握住绳子或树木，作为获得力量和稳定性的一种方式，以便用足够的力量推动婴儿。尽管有证据支持直立姿势对妇女及其未出生的孩子有益，但医疗机构始终提倡使用仰卧姿势。本研究的目的是探讨母亲和护士助产士对于在分娩过程中使用仰卧位的看法和经验。方法我们采用描述性定性设计。我们对护士助产士进行了七次半结构化访谈，并与特意招募参加该研究的产后母亲进行了两次焦点小组讨论。定性内容分析指导了分析。结果四个主题来自母亲和助产士对分娩期间使用仰卧位的经历和看法的描述。这些是： 妇女按照助产士的指示采取仰卧位；妇女使用替代分娩姿势的经验；助产士通常为产妇决定分娩姿势，仰卧位是最常见的分娩姿势。结论女性在分娩时使用仰卧位是因为护士助产士指导她们这样做。助产士护士认为仰卧位是众所周知和普遍采用的分娩姿势，并且更喜欢这种姿势，因为它为她们提供了灵活性，可以持续监测产程进展并最有效地协助分娩。这项研究中的母亲别无选择，只能按照指示以仰卧位分娩和分娩婴儿，因为她们相信助产士是熟练的专业人员，知道根据母亲和婴儿的情况什么是最好的。
BackgroundBefore the advent of Western medicine in Tanzania, women gave birth in an upright position either by sitting, squatting or kneeling. Birthing women would hold ropes or trees as a way of gaining strength and stability in order to push the baby with sufficient force. Despite the evidence supporting the upright position as beneficial to the woman and her unborn child, healthcare facilities consistently promote the use of the supine position. The purpose of this study was to explore the perceptions and experiences of mothers and nurse-midwives regarding the use of the supine position during labour and delivery.MethodsWe used a descriptive qualitative design. We conducted seven semi-structured interviews with nurse-midwives and two focus group discussions with postnatal mothers who were purposively recruited for the study. Qualitative content analysis guided the analysis.ResultsFour themes emerged from mothers' and midwives' description of their experiences and perceptions of using supine position during childbirth. These were: women adopted the supine position as instructed by midwives; women experience of using alternative birthing positions; midwives commonly decide birthing positions for labouring women and supine position is the best-known birthing position.ConclusionWomen use the supine position during childbirth because they are instructed to do so by the nurse-midwives. Nurse-midwives believe that the supine position is the universally known and practised birthing position, and prefer it because it provides flexibility for them to continuously monitor the progress of labour and assist delivery most efficiently. Mothers in this study had no other choice than to labour and deliver their babies in the supine position as instructed because they trusted midwives as skilled professionals who knew what was best given the condition of the mother and her baby.