The effectiveness of a Chinese midwives' antenatal clinic service on childbirth outcomes for primipare: A randomised controlled trial.
Background: Antenatal care is an important component of maternity care. In many parts of the world, midwives are the primary caregivers for childbearing women, providing a high level of continuity of care during a normal pregnancy. While in China, obstetricians are the primary providers of antenatal...
| Publicado en: | International Journal of Nursing Studies Vol. 50; no. 12; pp. 1689 - 1698 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Elsevier B.V.
2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104152574&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104152574 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00207489 JHV jtl: International Journal of Nursing Studies issn: 00207489 maglogo: N pubinfo: dt: 2013 vid: 50 iid: 12 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 104152574 91683118 10.1016/j.ijnurstu.2013.05.001 NLM23735597 104152574 ppf: 1689 ppct: 9 formats: fmt: @attributes: type: P tig: atl: The effectiveness of a Chinese midwives' antenatal clinic service on childbirth outcomes for primipare: A randomised controlled trial. aug: au: Chunyi Gu Xiaodan Wu Yan Ding Xinli Zhu Zheng Zhang affil: Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China sug: subj: Midwives Midwifery Midwifery Service Prenatal Care Pregnancy Outcomes Primiparas Funding Source Randomized Controlled Trials China Obstetric Patients Patient Satisfaction Pregnancy Academic Medical Centers Perinatal Nursing Physicians Comparative Studies Record Review Self Report Questionnaires Descriptive Statistics Power Analysis Vaginal Birth Cesarean Section Mental Status Summated Rating Scaling Scales Female Adult Educational Status Data Analysis Software Chi Square Test P-Value State-Trait Anxiety Inventory Apgar Score Psychological Tests Confidence Intervals Human Adult: 19-44 years Female ab: Background: Antenatal care is an important component of maternity care. In many parts of the world, midwives are the primary caregivers for childbearing women, providing a high level of continuity of care during a normal pregnancy. While in China, obstetricians are the primary providers of antenatal care for all childbearing women; and midwives only provide intrapartum care to labouring women. Today midwifery as a profession in China has been marginalised. Pregnant women usually lack individualised continuity of care from midwives during the perinatal period. There have been few randomised controlled trials of midwifery care practice in mainland China. Objective: (1) To develop and implement a model of Chinese midwives' antenatal clinic service and (2) to explore its effect on childbirth outcomes, psychological state and satisfaction, for primiparae. Design and methods: Two-group randomised controlled trial. One hundred and ten pregnant women were assessed for eligibility and invited to participate in either the intervention group (midwives' antenatal clinic service) or the control group (routine antenatal care) in the Obstetrics and Gynaecology Hospital of Fudan University from September 2011 to December 2011. Baseline data were collected, and then women were randomised to individual midwives' antenatal clinic care (intervention group) or regular antenatal clinic service by obstetricians and obstetric nurse (control group). The research hypothesis was that compared with regular obstetrician-led antenatal care, the midwives' antenatal clinic service would decrease the caesarean section rate, produce more favourable birth outcomes and women's greater satisfaction with care. Data were collected by retrospective review of case records and self-report questionnaires. The sample size of 110 was calculated to identify a decrease in caesarean birth from 70% to 40%. Birth outcomes, satisfaction and anxiety score in the two groups were compared. Setting: The midwives' antenatal clinic in the Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China. Participants: 55 women, attending the midwives' antenatal clinic (the intervention group) and 55 women, entering the control group. Results: Women in the intervention group were more likely than women in the control group to have a vaginal birth (35 [66.04%] versus 23 [43.40%]; 95% CI for difference 3.69- 41.60). Women in the intervention group had a higher perinatal satisfaction but lower anxiety score than those in the control group. No differences were seen in neonatal Apgar score and in the amount of bleeding 2 h post partum. Conclusion and implications for practice: The midwives' antenatal clinic can decrease the rate of caesarean section and enhance women's satisfaction with midwifery care. Further research needs to be conducted to implement this model of care more widely. We will attempt to make midwifery care a true choice for Chinese women. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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