A Study of Analyzing the Japanese Collaboration Model during Labor between Obstetricians and Midwives at Hospitals

点击翻译按钮获取中文摘要

We made the hypothesis about the collaborative model between obstetricians and midwives to care the pregnant women during labor. The model explains following situations. The midwife observes and takes care of the pregnant women continuously or intermittently. Usually she reports that observation data to the obstetrician. Sometimes the obstetrician uses the information data from the midwife. Sometimes the obstetrician observes directly. If the midwife takes care continuously and the pregnant woman is low-risk, the midwife has much information of the pregnant woman, so she makes decisions about how to care for the pregnant women. If the midwife takes care intermittently, the midwife doesn't have much information, so the obstetrician tends to gather the information directly. But if the situation becomes high-risk, the obstetrician makes decisions about the medical intervention, so the obstetrician depends upon his/her own data whether the midwife's care is continuously or intermittently. To analyze the model, we took four analyzing process. First we re-analyzed our 44 hospitals data gathered in 1999, second we made case analysis of the samples of the progress charts at a university hospital and a big size private hospital, and third we surveyed the collaborative situations between obstetricians and nurse-midwives in hospital that has over 300 beds in Japan. And forth, we hypothesized "monitoring-c are" for the pregnant women during labor by midwives. The results of our analysis suggest that obstetricians and midwives who work at Japanese hospitals take cooperative care of both low risk pregnant women and high risk women under complex and difficult working situations. For the future, we hope to identify effectiveness of these collaborations and make the better caring situation for both mothers and children.