The Structurization and Verification of Skills in Expert Midwife's Monitoring-Care during Labor and Delivery

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During 2004, we tried to identify "monitoring-care" by expert nurse-midwife during labor and delivery. After literature review including our former researches and discussion among us, we coded the purpose of the "monitoring-care" as fetus's wellness, reassuring the woman's safety, grasping the progress of delivery, and grasping the woman's sense of control.During 2005, we use above research results and our discussion, and we tried to make the program of the monitoring and caring process during labor and delivery cared. Using algorithm notion method developed by Tsuru, S., our co-researcher, we made the clinical process chart of monitoring and caring process during labor and delivery. To brush up and verify that clinical process chart, we applied that program to 60 clinical cases delivered at 2^<nd> level prenatal obstetrical unit from Jan.1^<st> to Mar.20^<th> in 2006. We used virginal 41 delivery cases and 19 emergency or scheduled caesarian section cases, and these were relatively low-risk cases. As results, we couldn't find any deviations of that clinical chart, but found we must add some new units, for example rupture of membrane, induced labor and/or fetus assurance so on, and reexamine the criteria of these units.Our trial of making clinical process chart was at same time the trial of making structural visualization of the process of expert nurse-midwife's monitoring and caring during labor and delivery. Visualizing the thinking processes and the practice of expert nurses-midwives which have not been expressly stated previously can become a foundation for more advanced nursing care throughout the profession.