Health promotion in pregnancy: the role of the midwife
Health promotion in pregnancy: the role of the midwife
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DOI：
10.1177/146642400512500513
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发表时间：
2005-09-01
期刊：
影响因子：
--
通讯作者：
Crozier, Suzanne
中科院分区：
文献类型：
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作者：
Beldon, Annemarie;Crozier, Suzanne
对助产士来说，促进健康尤其重要，因为他们促进健康，而不是管理疾病和不健康。虽然助产士一直在公共卫生方面发挥作用，但现在显然需要这一职业关注少女怀孕、戒烟、提高对毒品的认识和家庭暴力。助产士在怀孕期间的主要职责是促进健康，更明确地应用这些职责可能有利于执行政府的公共卫生政策，助产士开展的一些活动可能不属于促进健康，但有证据表明，例行检查产生的相互作用有利于母亲的健康。助产士应与妇女和家庭合作，促进关于她们可能需要的护理的决定。如果正规教育不受重视，或者由于种族或语言背景而无法获得传统的分娩教育，社会不利因素可能会阻碍参与。解决这一问题是当前围绕分娩和儿童保育的公共卫生政策的核心。教育可以在任何互动中进行，这给了助产士巨大的空间，每次见面都能为妇女提供教育经验。对于怀孕少女，可能需要将大家庭纳入健康促进活动，特别是如果要实现母乳喂养的目标。可能需要制定一项统一的卫生和教育政策，向儿童和青少年宣传和教育孕前护理和母乳喂养的好处。通过这种方式，年轻妇女在怀孕之前、在对母乳喂养的态度确立之前和在孕前护理的概念丧失之前就与助产士接触。虽然母乳喂养改善了妇女及其婴儿的健康，但它可能成为另一种负担和期望，而她们无法实现。专业人员需要敏感地认识到对妇女健康可能产生的负面影响，如果重点从个人行为改变转移到社会内部的不平等，这种影响可能会减少，助产士应努力对服务变化作出积极反应，以实现多学科、不分等级的以病人为中心的服务目标。在促进变革方面，助产士力求利用其影响力为孕妇谋福利。
Health promotion is of particular importance to midwives who promote health rather than manage disease and ill health. Although the midwife has always had a role in public health, there is now an explicit need for the profession to direct its attention to teenage pregnancy, smoking cessation, drug awareness and domestic violence. Much of the rote of the midwife during pregnancy is in health promotion and a more explicit application of such may carry benefits in meeting Government policy on public health.Some activities undertaken by midwives may not be identified as health promotion, though there is evidence that the interaction generated by routine examinations is of benefit to the mother's health. Midwives should work in partnership with women and families, facilitating decisions about the care that they feet they may require. Social disadvantage may impede participation where formal education was not valued or ethnic background or language impaired access to traditional childbirth education. Tackling this is at the heart of current public health policy around childbirth and child care.Education can take place during any interaction and this gives midwives huge scope to provide an educational experience for women each time they meet. For the pregnant teenager the extended family may need to be included in health promotion activities particularly if breastfeeding targets are to be met. A united health and education policy to inform and educate children and teenagers about the benefits of pre-conceptional care and breastfeeding may be needed. In this way young women come into contact with midwives before they are pregnant, before attitudes to breastfeeding are established and before the concept of pre-conceptional care is lost. Although breastfeeding improves health for women and their infants it can become another burden and expectation which they fail to achieve. Professionals need to be sensitive to the possible negative impact on a woman's health, which could be reduced if the emphasis was moved from individual behaviour change to the inequalities within society.Midwives should seek to respond positively to service changes to achieve the goal of multidisciplinary, non-hierarchical patient-centred services. In facilitating change midwives seek to use their influence to the benefit of the pregnant woman.