Establishment of mental care support for midwives in the midwife-led perinatal care clinic

为了建立助产士主导的围产期保健诊所的助产士心理保健体系，我们首先进行了一项调查，以了解东北大学医院助产士主导的围产期心理保健诊所已经建立了助产士心理保健体系的情况。我们在调查中发现，使用者往往存在产后抑郁症(PPD)的各种危险因素。其次，我们对使用助产士主导的围产期护理诊所的孕妇和哺乳母亲以及在宫城县诊所工作的助产士进行了实质性调查。我们从问卷调查的结果中发现，他们的精神状态不稳定。访谈调查结果显示，他们没有从丈夫和母亲那里得到足够的支持，而母亲成了支持的中心。根据这些发现，我们对在助产士主导的围产期护理诊所工作的助产士进行了一项关于心理护理系统的干预研究。在临床心理学家介入以缓解助产士的问题后，能够为孕妇和哺乳母亲提供良好支持的助产士数量显著增加

For the purpose of establishing a mental care system by midwives who work at midwife-led perinatal care clinics, first, we carried out a survey in order to understand the conditions at the midwife-led perinatal psychological care clinic in Tohoku University Hospital at which a mental care system has already been organized by midwives. We found that the users had often various risk factors of postpartum depression (PPD)in the survey. Second, we carried out a substantial investigation for the expectant and nursing mothers who used midwife-led perinatal care clinics and for the midwives who worked at the clinics in Miyagi Prefecture. We found from the results of the questionnaire investigation that they were mentally unstable. The result of the interview investigation showed that they did not receive enough support from their husband and their mother, who became the center of support. From these findings, we carried out an intervention study regarding the mental care system for midwives who worked at midwife-led perinatal care clinics. After a clinical psychologist intervened in order to alleviate the problems with the midwives, the number of the midwives who could provide good support for the expectant and nursing mothers significantly increased