| Abstrakt: |
Purpose The purpose of this study was to make clear problems on women's labour positions from the perspective of midwives in hospital in order to promote alternative labour positions in midwifery in Japan. Method Self-administered survey questionnaires from 367 midwives from 16 hospitals encouraging women to use alternative labour positions, and 20 other hospitals were eligible for analysis. Question items included age, years of experience at a hospital and as a midwife, wishes to use alternative labour positions, opinions of maternal and foetal conditions, labour progress, birth environment and obstetric interventions (12 items) in non-supine positions, and anxiety in midwifery in assisting births in non-supine positions. Correlation analysis, Mann-Whitney U test and Kruskal-Wallis test were used to compare views mainly between two groups of midwives, one group where nonsupine positions were used and the other where non supine positions were not used. Results 65.6% of midwives in hospitals using non-spine positions had used non-supine positions during the second stage of labour. 93.0% of midwives whose hospitals do not use non-supine positions were considered desirable for using alternative labour positions. Nevertheless only 74.5% wished to use them, and 85.5% wished to promote those who work at hospitals using non-supine positions routinely. The biggest obstruction in using non-supine labour positions is midwifery (34.9%). Noncooperation of obstetricians and routine supine position use were problems for midwives whose hospitals used only supine position. Subsequently, problems of facilities, environment of labour, and shortage of midwives were indicated. Significant relations were found between wishes for using non-supine positions and their experience or anxiety in midwifery. Conclusions The decline of implementation of alternative positions showed factors of stagnation in the desire for its promotion. Midwives in hospitals using non-supine positions need to be able to gain more experience in studying for assisting births in non-supine positions, and improve their midwifery practices. Midwives and obstetricians need to have a course of action for providing consistent care of midwifery of labour positions for women. It is important for midwives in hospitals to realize the physiological effectiveness of non-supine positions and discuss the procedure of obstetric interventions for an emergency in order to be possible to provide organized treatment of midwifery. [ABSTRACT FROM AUTHOR] |
