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朱梅光 《安徽农业大学学报(社会科学版)》2017,26(2):134-140
对民国农村产妇的分娩救助,主要以培训与普及新型女性医疗照顾者为中心来展开.有识之士在农村努力扩充助产士,以其全新"医学化"的接产形态,建构农村妇婴卫生事业建设的主要趋向."本地化"路线下的旧式产婆改造,以借力之法,实现新旧嫁接,将本处于淘汰之列的产婆群体重新纳入正规助产职业者的行列中."外行化"理念下的助产妇培训,以扩大训练范围为宗旨,进一步充实了农村基层分娩卫生系统的基础.三种模式相互叠加,对当时妇婴卫生的改良发挥了重要的作用. 相似文献
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Kate Dawson Della A. Forster Helen L. McLachlan Michelle S. Newton 《Women and birth : journal of the Australian College of Midwives》2018,31(3):194-201
Background
Despite high-level evidence of the benefits of caseload midwifery for women and babies, little is known about specific practice arrangements, organisational barriers and facilitators, nor about workforce requirements of caseload. This paper explores how caseload models across Australia operate.Methods
A national cross-sectional, online survey of maternity managers in public maternity hospitals with birthing services was undertaken. Only services with a caseload model are included in the analysis.Findings
Of 253 eligible hospitals, 149 (63%) responded, of whom 44 (31%) had a caseload model. Operationalisation of caseload varied across the country. Most commonly, caseload midwives were required to work more than 0.5 EFT, have more than one year of experience and have the skills across the whole scope of practice. On average, midwives took a caseload of 35–40 women when full time, with reduced caseloads if caring for women at higher risk. Leave coverage was complex and often ad-hoc. Duration of home-based postnatal care varied and most commonly provided to six weeks. Women’s access to caseload care was impacted by many factors with geographical location and obstetric risk being most common.Conclusion
Introducing, managing and operationalising caseload midwifery care is complex. Factors which may affect the expansion and availability of the model are multi-faceted and include staffing and model inclusion guidelines. Coverage of leave is a factor which appears particularly challenging and needs more focus. 相似文献5.
Elizabeth C. Rigg Virginia Schmied Kath Peters Hannah G. Dahlen 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e77-e87
Background
In Australia, the provision of homebirth services by unregulated birthworkers (doulas, ex-registered midwives, traditional midwives and lay workers) has increased. Accessing a homebirth with a registered midwife via mainstream services is limited. Concern is growing that new legislation aimed at prohibiting unregulated birthworkers practice may result in homebirth going underground.Aim
To explore the role, practice and training of unregulated birthworkers in Australian and establish what they would do if legislation prohibited their practice.Methods
This study used a mixed methods sequential exploratory design to explore the practice, training and role of unregulated birthworkers in Australia. In phase one, four unregulated birthworkers were interviewed in-depth and the findings informed the development of a survey in phase two. This was distributed nationally through two consumer websites, social media, Facebook and email. Data from both phases were integrated.Findings
Unregulated birthworkers in Australia provide homebirth services to women with high and low-risk pregnancies when this choice is unavailable or unacceptable within mainstream services. They operate covertly to protect their practice and avoid the scrutiny of authorities. Unregulated birthworkers can be experienced and trained in childbirth care and practice, much like a midwife working within a holistic paradigm of care.Conclusion
Unregulated birthworkers believe they provide women with the homebirth service they want but cannot access. Mainstream service providers need to listen to consumer criticisms, as women seek answers outside the system. Change is needed to improve and align services with women’s expectations of homebirth. 相似文献6.
Linda Sweet Janice Bass Mary Sidebotham Jennifer Fenwick Kristen Graham 《Women and birth : journal of the Australian College of Midwives》2019,32(2):119-126
Background
Practice-based or clinical placements are highly valued for linking theory to practice and enabling students to meet graduate outcomes and industry standards. Post-practicum, the period immediately following clinical experiences, is a time when students have an opportunity to share, compare and engage critically in considering how these experiences impact on their learning. Reflective practice has merit in facilitating this process.Aim
This project aimed to optimise the learning potential of practice-based experiences by enhancing midwifery students’ capacity for reflective practice through writing.Methods
Design-based research was used to implement an educational intervention aimed at developing reflective practice skills and enhance reflective writing. The Bass Model of Holistic Reflection was introduced to promote the development of reflective capacity in midwifery students. Academics and midwifery students were provided with guidance and resources on how to apply the model to guide reflective writing. Students’ written reflections completed before (n = 130) and after the introduction of the intervention (n = 96) were evaluated using a scoring framework designed to assess sequential development of reflective capacity.Findings
The pre-intervention scores ranked poorly as evidence of reflective capacity. All scores improved post-intervention.Conclusions
The introduction of a holistic structured model of reflection resulted in improved scores across all five components of reflective writing; self-awareness, sources of knowledge, reflection and critical reflection, evidence informed practice and critical thinking. While further work is required the results show that the implementation process and use of the Bass Model enables students to demonstrate their capacity to reflect-on-practice through their writing. 相似文献7.
清末民初以来,中国的妇女生育逐渐经历了一场基于西医知识体系的医疗化过程,这是中国社会近代化的组成部分。然而,相比于关于这一时期中西医的一般论争,西医在产科医疗领域主导地位的确立以及相应的医疗新秩序的建立,较少受到学界的关注。文章以产婆的规训和被污名化作为具体切入点,探讨西医的宣传者与捍卫者在与传统中医竞争过程中所采取的知识或社会策略,认为西医知识系统在产科医疗领域的确立,很大程度上并非依赖于其知识和技术的“先进性”,而更多的是社会和文化等多种因素共同作用的结果。 相似文献
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J. Fenwick H. Brittain J. Gamble 《Women and birth : journal of the Australian College of Midwives》2017,30(6):497-505
Background
Reporting the outcomes for women and newborns accessing private midwives with visiting rights in Australia is important, especially since this data cannot currently be disaggregated from routinely collected perinatal data.Aim
1) Evaluate the outcomes of women and newborns cared for by midwives with visiting access at one Queensland facility and 2) explore private midwives views about the structures and processes contributing to clinical outcomes.Methods
Mixed methods. An audit of the ‘all risk’ 529 women receiving private midwifery care. Data were compared with national core maternity variables using Chi square statistics. Telephone interviews were conducted with six private midwives and data analysed using thematic analysis.Findings
Compared to national data, women with a private midwife were significantly more likely to be having a first baby (49.5% vs 43.6% p = 0.007), to commence labour spontaneously (84.7% vs 52.7%, p < 0.001), experience a spontaneous vaginal birth (79% vs 54%, p < 0.001) and not require pharmacological pain relief (52.9% vs 23.1%, p < 0.001). The caesarean section rate was significantly lower than the national rate (13% vs 32.8%, p < 0.001). In addition fewer babies required admission to the Newborn Care Unit (5.1% vs 16%, p < 0.001). Midwives were proud of their achievements. Continuity of care was considered fundamental to achieving quality outcomes. Midwives valued the governance processes embedded around the model.Conclusions
Private midwives with access to the public system is safe. Ensuring national data collection accurately captures outcomes relative to model of care in both the public and private sector should be prioritised. 相似文献9.
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