Doğum Alanında Çalışan Sağlık Profesyonellerinin Vajinal Doğumların Yönetilmesine İlişkin Düşüncelerinin Belirlenmesi: Nitel Bir Araştırma
Yıl 2024,
Cilt: 5 Sayı: 2, 12 - 21, 27.08.2024
Keziban Amanak
,
Sibel Şeker
,
Funda Çitil Canbay
,
Pınar Serçekuş
Öz
Araştırma, jinekoloji alanında çalışan sağlık profesyonellerinin vajinal doğumların yönetimine ilişkin görüşlerini belirlemek amacıyla yapılmıştır. Araştırma, Türkiye'nin batısında bir devlet üniversite hastanesinde vajinal doğumda aktif görev alan 18 sağlık çalışanı ile gerçekleştirilmiştir. Amaçlı örnekleme yöntemlerinden maksimum çeşitlilik örnekleme yöntemi kullanılmıştır. Araştırma verileri bilgi formu ve yapılandırılmış bilgi formu aracılığıyla toplanmıştır. Tematik analiz yöntemi ile analiz edilmiştir. Etik onay alınmıştır. Bu araştırmada vajinal doğumların yönetimi ile ilgili üç ana tema belirlenmiştir. (I) Vajinal doğumların yönetimine ilişkin ebelerin görüşleri, (II) Vajinal doğumların yönetimine ilişkin hemşirelerin görüşleri ve (III) Vajinal doğumların yönetimine ilişkin doktorların görüşleri. Katılımcılar (özellikle ebeler ve doktorlar) vajinal doğum sorumluluğu konusunda genel olarak kendilerini önemli bir aktivist olarak gördüklerini ve ebelerin iş yoğunluğu ve gebelerin ebeler tarafından takip edilmesi nedeniyle vajinal doğum yapabildiklerini belirtmişlerdir. Ebe ve hemşireler doğumun sadece tıbbi bir eylem olmadığını, gebelik, doğum ve doğum sonrası dönemde aktif bakım gerektiren önemli sorumluluklar getirdiğini vurgulamışlardır. Sağlık profesyonellerinin bakış açısı çoğunlukla yeterli eğitim ve beceriye sahip tüm ebelerin vajinal doğumları bağımsız olarak yapabilecekleri yönünde olmuştur. Teslimatı yapacak ekibe teorik ve pratik olarak sürekli kurumsal eğitimler verilmesi konusunda anlaştılar. Özellikle üniversite hastanelerinde hemşire ve ebelerin bir ekibin parçası olarak vajinal doğumlarda görevlerini bağımsız olarak yerine getirebilmeleri ve sorumluluklarını artırabilmeleri konusunda aktif çalışmaların planlanması gerekmektedir.
Etik Beyan
Approval was received from the Non-invasive Clinical Research Ethics Committee of the hospital where the research was carried (Number : 92340882-050.04.04).
Destekleyen Kurum
The expenses of the research were covered by the authors.
Teşekkür
We would like to thank the academicians whose scientific opinions we received in this study.
Kaynakça
- Romijn A, Muijtjens Ir AM, de Bruijne MC, Donkers HH, Wagner C, de Groot CJ, Teunissen PW. What is normal progress in the first stage of labour? A vignette study of similarities and differences between midwives and obstetricians. Midwifery. 2016;41:104-109. https://doi:10.1016/j.midw.2016.08.006.
- Ayerle GM, Schäfers R, Mattern E, Striebich S, Haastert B, Vomhof M, Icks A, Ronniger Y, Seliger G. Effects of the birthing room environment on vaginal births and client-centred outcomes for women at term planning a vaginal birth: BE-UP, a multicentre randomised controlled trial. Trials. 2018;19(1):641.. https://doi: 10.1186/s13063-018-2979-7.
- Erenel A, Çiçek S. Effects of İnterventions in childbirth on health of mother and child interventions in childbirth. SDÜ Journal of Health Sciences Institute. 2018;(2):2018.
- Long Q, Allanson ER, Pontre J, Tunçalp Ö, Hofmeyr GJ, Gülmezoğlu AM. Onsite midwife-led birth units (OMBUs) for care around the time of childbirth : A systematic review. BMJ Glob Health. 2016;1(2):e000096. https://doi: 10.1136/bmjgh-2016-000096.
- Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews. 2016;4: CD004667. https://doi: 10.1002/14651858.CD004667.pub5.
- Dencker A, Smith V, McCann C, Begley C. Midwife-led maternity care in Ireland: A retrospective cohort study. BMC Pregnancy Childbirth. 2017;17(1):101. https://doi: 10.1186/s12884-017-1285-9.
- Kearney L, Kynn M, Craswell A, Reed R. The relationship between midwife-led group-based versus conventional antenatal care and mode of birth: A matched cohort study. BMC Pregnancy Childbirth. 2017; 17(1):39. https://doi: 10.1186/s12884-016-1216-1.
- Bartuseviciene E, Kacerauskiene J, Bartusevicius A, Paulionyte M, Nadisauskiene RJ, Kliucinskas M, Stankeviciute V, Maleckiene L, Railaite DR. Comparison of midwife-led and obstetrician-led care in Lithuania: A retrospective cohort study. Midwifery. 2018;65:67-71. https://doi: 10.1016/j.midw.2018.06.017.
- Bodner-Adler B, Kimberger O, Griebaum J, Husslein P, Bodner K. A ten-year study of midwife-led care at an Austrian tertiary care center: A retrospective analysis with special consideration of perineal trauma. BMC Pregnancy Childbirth. 2017;17(1):357. https://doi: 10.1186/s12884-017-1544-9.
- Monari F, Di Mario S, Facchinetti F, Basevi V. Obstetricians' and midwives' attitudes toward cesarean section. Birth. 2008;35(2):129-135. https://doi: 10.1111/j.1523-536X.2008.00226.x.
- Kısa S, Kısa A, Younis MZ. (2017). Opinions and attitudes of obstetricians and midwives in Turkey towards caesarean section and vaginal birth following a previous caesarean section. J Int Med Res. 2017;45(6) :1739-1749. https://doi: 10.1177/0300060516663998.
- Healy S, Humphreys E, Kennedy C. Midwives and obstetricians perceptions of risk and its impact on clinical practice and decision-making in labour: An integrative review. Women Birth. 2016;29(2):107-116. https://doi: 10.1016/j.wombi.2015.08.010.
- Betrán AP, Temmerman M, Kingdon C, Mohiddin A, Opiyo N, Torloni MR, Zhang J, Musana O, Wanyonyi SZ, Gülmezoglu AM, Downe S. Interventions to reduce unnecessary caesarean sections in healthy women and babies. Lancet. 2018;392(10155):1358-1368. https://doi: 10.1016/S0140-6736(18)31927-5.
- Türkiye Nüfus ve Sağlık Araştırması (TNSA). Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Doğum hizmetleri. Maternity services. Specialist to Help Birth. ISBN 978-975-491-493-1 115. 2018. Access: www.hips.hacettepe.edu.tr. Access date: 05.09.20.
- Ergöçmen BA, Çavlin A, Özgören AA. Reproductive health. Ankara: Türkiye Nüfus ve Sağlık Araştırması, Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Kalkınma Bakanlığı ve TÜBİTAK. 2014, Access date: 2018 Feb 5. Access: http://www.hips.hacettepe.edu.tr. pp.150-151.
- Okumuş F. Midwifery-led models of care for childbearing women: the Netherlands as an example. International Refereed Journal of Gynaecology And Maternal Child Health Compilation. 2016; 7:120-141.
- Tong A, Sainsbury P, Craig J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–357. http://doi: 10.1093/intqhc/mzm042.
- Morrow R, Rodriguez A, King N. Colaizzi’s descriptive phenomenological method. The Psychologist. 2015;28(8):643-644.
- Bodner-Adler B, Bodner K, Kimberger O, Lozanov P, Husslein P, Mayerhofer K. Influence of the birth attendant on maternal and neonatal outcomes during normal vaginal delivery: A comparison between midwife and physician management. Wien Klin Wochenschr. 2004;116(11-12):379-384. http://doi: 10.1007/BF03040917.
- Güner S, Yurdakul M, Yetim N. A Qualitative Study on the Academic Approach to the Professionalization of Midwifery in Turkey. Journal of Higher Education and Science. 2015;5(1):80-87. http://doi: 10.5961/jhes.2015.111.
- Behruzi R, Klam S, Dehertog M, Jimenez V, Hatem M. Understanding factors affecting collaboration between midwives and other health care professionals in a birth center and its affiliated Quebec hospital: A case study. BMC Pregnancy Childbirth. 2017;17(1):200. http://doi: 10.1186/s12884-017-1381-x.
- Türkiye Nüfus ve Sağlık Araştırması (TNSA). Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Doğum hizmetleri. Maternity services. Specialist to Help Birth. ISBN 978-975-491-493-1 115. 2018. Access: www.hips.hacettepe.edu.tr. Access date: 05.09.20.
- Seibold C, Licqurish S, Rolls C, Hopkins F. Corrigendum to ‘‘lending the space': Midwives' perceptions of birth space and clinical risk management’, Midwifery. 2011;27(5):526–531.
- Vural G, Erenel AŞ. Why did medicalization of birth increase, Can we reduce it? Journal of Hacettepe University Faculty of Nursing. 2017;4(2):76-83.
- Elmir R, Pangas J, Dahlen H, Schmied V. A meta-ethnographic synthesis of midwives' and nurses' experiences of adverse labour and birth events. J Clin Nurs. 2017;26(23-24):4184-4200. http://doi: 10.1111/jocn.13965.
- Ulusoy H, Moroğlu Tokgöz D. The views of doctors and nurses on teamwork. Pamukkale Medical Journal. 2009;2(2):55-61.
- Öğüt A, Kaya ŞD. Teamwork in healthcare institutions. Selcuk University Kadinhanı Faik İçil Vocational School Journal of Social and Technical Research. 2011;1(1):87-95.
- DeJoy SA, Sankey HZ, Dickerson AE, Psaltis A, Galli A, Burkman RT. The Evolving Role of Midwives as Laborists. J Midwifery Womens Health. 2015;60(6):674-681. http://doi: 0.1111/jmwh.12350.
- Çelik A, Karaca A. Evaluating the relationship between teamwork and motivation in nurses and affecting factors. Journal of Education and Research in Nursing. 2017;14(4):254-263. http://doi:10.5222/HEAD.2017.254.
- Güleç Şatır D, Ünsal Atan Ş, Taner A, Gün S. Determining the knowledge and opinions of nurses and midwives working in gynecology clinics regarding natural birth and birthing interventions. Journal of Education and Research in Nursing. 2018;15(4):222-227.
- Chen I, Opiyo N, Tavender E, Mortazhejri S, Rader T, Petkovic J, Yogasingam S, Taljaard M, Agarwal S, Laopaiboon M, Wasiak J, Khunpradit S, Lumbiganon P, Gruen RL, Betran AP. (2018). Non-clinical interventions for reducing unnecessary caesarean section. Cochrane Database Syst Rev. 2018;9(9): CD005528. http://doi: 10.1002/14651858.CD005528.pub3.
- Seijmonsbergen-Schermers A, van den Akker T, Beeckman K, Bogaerts A, Barros M, Janssen P, Binfa L, Rydahl E, Frith L, Gross MM, Hálfdánsdóttir B, Daly D, Calleja-Agius J, Gillen P, Vika Nilsen AB, Declercq E, de Jonge A. Variations in childbirth interventions in high-income countries: Protocol for a multinational cross-sectional study. BMJ Open. 2018;8(1):e017993. http://doi: 10.1136/bmjopen-2017-017993.
- Bilgin Z, Ocakçı AF. (2011). The professional motivation of midwifery students. Journal of Anatolia Nursing and Health Sciences. 2011;14(3):40-46.
- Aslan Ş, Okumuş F. (2017). The influence of childbirth expectation on primiparous women’s perceptions of their birth experience. HSP. 2017;4(1):32-40. http://doi: 10.17681/hsp.287497.
- Yapça ÖE, Karaca İ, Çatma T. How can we reduce the increasing primary cesarean rates? Evaluation of our 3-year data of cesarean sections. IKSSTD. 2015;7(3):97-102.
- Karaçam Z. (2016). The state of the midwifery as a professional career in turkey: Legal regulations, education and research. Lokman Hekim Journal. 2016;6(3):128-136.
- Başkaya Y, Sayıner FD. Evidence-Based Midwifery Practices to Reduce Cesarean Rat. HSP. 2018;5(1):113-119. doi:10.17681/hsp.335472
Opinions of Health Professionals about the Management of Vaginal Deliveries: A Qualitative Research
Yıl 2024,
Cilt: 5 Sayı: 2, 12 - 21, 27.08.2024
Keziban Amanak
,
Sibel Şeker
,
Funda Çitil Canbay
,
Pınar Serçekuş
Öz
The research aimed to identify the opinions of health professionals working in the field of obstetrics about the management of vaginal deliveries. The research was carried out with 18 health professionals having active duties in vaginal deliveries at a state university hospital in western Turkey. The maximum variation sampling method, one of the purposive sampling methods, was used. The research data were collected through information form and structured information form. They were analyzed through the thematic analysis method. Ethic Approval was received. Three main themes were identified about the management of vaginal deliveries in this research. (I) opinions of midwives about the management of vaginal deliveries, (II) opinions of nurses about the management of vaginal deliveries and (III) opinions of doctors about the management of vaginal deliveries. The participants (especially midwives and doctors) stated that they overall viewed themselves as a significant activist in the responsibility for vaginal delivery, and midwives could carry out vaginal deliveries due to the workload and the fact that the pregnant women were followed up by midwives. Midwives and nurses emphasized that delivery was not only a medical action but also brought significant responsibilities requiring active care in pregnancy, delivery and the postpartum. The perspective of health professionals was mainly in the direction of the fact that all midwives, who had sufficient education and skills, could carry out vaginal deliveries independently. They agreed that the team who would carry out the delivery should be given continuous institutional training in terms of theory and practice. It is necessary that active studies should be planned on matter of the fact that especially the nurses and midwives in university hospitals could carry out their independent duties and increase their responsibilities for vaginal deliveries as a part of a team.
Kaynakça
- Romijn A, Muijtjens Ir AM, de Bruijne MC, Donkers HH, Wagner C, de Groot CJ, Teunissen PW. What is normal progress in the first stage of labour? A vignette study of similarities and differences between midwives and obstetricians. Midwifery. 2016;41:104-109. https://doi:10.1016/j.midw.2016.08.006.
- Ayerle GM, Schäfers R, Mattern E, Striebich S, Haastert B, Vomhof M, Icks A, Ronniger Y, Seliger G. Effects of the birthing room environment on vaginal births and client-centred outcomes for women at term planning a vaginal birth: BE-UP, a multicentre randomised controlled trial. Trials. 2018;19(1):641.. https://doi: 10.1186/s13063-018-2979-7.
- Erenel A, Çiçek S. Effects of İnterventions in childbirth on health of mother and child interventions in childbirth. SDÜ Journal of Health Sciences Institute. 2018;(2):2018.
- Long Q, Allanson ER, Pontre J, Tunçalp Ö, Hofmeyr GJ, Gülmezoğlu AM. Onsite midwife-led birth units (OMBUs) for care around the time of childbirth : A systematic review. BMJ Glob Health. 2016;1(2):e000096. https://doi: 10.1136/bmjgh-2016-000096.
- Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews. 2016;4: CD004667. https://doi: 10.1002/14651858.CD004667.pub5.
- Dencker A, Smith V, McCann C, Begley C. Midwife-led maternity care in Ireland: A retrospective cohort study. BMC Pregnancy Childbirth. 2017;17(1):101. https://doi: 10.1186/s12884-017-1285-9.
- Kearney L, Kynn M, Craswell A, Reed R. The relationship between midwife-led group-based versus conventional antenatal care and mode of birth: A matched cohort study. BMC Pregnancy Childbirth. 2017; 17(1):39. https://doi: 10.1186/s12884-016-1216-1.
- Bartuseviciene E, Kacerauskiene J, Bartusevicius A, Paulionyte M, Nadisauskiene RJ, Kliucinskas M, Stankeviciute V, Maleckiene L, Railaite DR. Comparison of midwife-led and obstetrician-led care in Lithuania: A retrospective cohort study. Midwifery. 2018;65:67-71. https://doi: 10.1016/j.midw.2018.06.017.
- Bodner-Adler B, Kimberger O, Griebaum J, Husslein P, Bodner K. A ten-year study of midwife-led care at an Austrian tertiary care center: A retrospective analysis with special consideration of perineal trauma. BMC Pregnancy Childbirth. 2017;17(1):357. https://doi: 10.1186/s12884-017-1544-9.
- Monari F, Di Mario S, Facchinetti F, Basevi V. Obstetricians' and midwives' attitudes toward cesarean section. Birth. 2008;35(2):129-135. https://doi: 10.1111/j.1523-536X.2008.00226.x.
- Kısa S, Kısa A, Younis MZ. (2017). Opinions and attitudes of obstetricians and midwives in Turkey towards caesarean section and vaginal birth following a previous caesarean section. J Int Med Res. 2017;45(6) :1739-1749. https://doi: 10.1177/0300060516663998.
- Healy S, Humphreys E, Kennedy C. Midwives and obstetricians perceptions of risk and its impact on clinical practice and decision-making in labour: An integrative review. Women Birth. 2016;29(2):107-116. https://doi: 10.1016/j.wombi.2015.08.010.
- Betrán AP, Temmerman M, Kingdon C, Mohiddin A, Opiyo N, Torloni MR, Zhang J, Musana O, Wanyonyi SZ, Gülmezoglu AM, Downe S. Interventions to reduce unnecessary caesarean sections in healthy women and babies. Lancet. 2018;392(10155):1358-1368. https://doi: 10.1016/S0140-6736(18)31927-5.
- Türkiye Nüfus ve Sağlık Araştırması (TNSA). Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Doğum hizmetleri. Maternity services. Specialist to Help Birth. ISBN 978-975-491-493-1 115. 2018. Access: www.hips.hacettepe.edu.tr. Access date: 05.09.20.
- Ergöçmen BA, Çavlin A, Özgören AA. Reproductive health. Ankara: Türkiye Nüfus ve Sağlık Araştırması, Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Kalkınma Bakanlığı ve TÜBİTAK. 2014, Access date: 2018 Feb 5. Access: http://www.hips.hacettepe.edu.tr. pp.150-151.
- Okumuş F. Midwifery-led models of care for childbearing women: the Netherlands as an example. International Refereed Journal of Gynaecology And Maternal Child Health Compilation. 2016; 7:120-141.
- Tong A, Sainsbury P, Craig J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–357. http://doi: 10.1093/intqhc/mzm042.
- Morrow R, Rodriguez A, King N. Colaizzi’s descriptive phenomenological method. The Psychologist. 2015;28(8):643-644.
- Bodner-Adler B, Bodner K, Kimberger O, Lozanov P, Husslein P, Mayerhofer K. Influence of the birth attendant on maternal and neonatal outcomes during normal vaginal delivery: A comparison between midwife and physician management. Wien Klin Wochenschr. 2004;116(11-12):379-384. http://doi: 10.1007/BF03040917.
- Güner S, Yurdakul M, Yetim N. A Qualitative Study on the Academic Approach to the Professionalization of Midwifery in Turkey. Journal of Higher Education and Science. 2015;5(1):80-87. http://doi: 10.5961/jhes.2015.111.
- Behruzi R, Klam S, Dehertog M, Jimenez V, Hatem M. Understanding factors affecting collaboration between midwives and other health care professionals in a birth center and its affiliated Quebec hospital: A case study. BMC Pregnancy Childbirth. 2017;17(1):200. http://doi: 10.1186/s12884-017-1381-x.
- Türkiye Nüfus ve Sağlık Araştırması (TNSA). Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Doğum hizmetleri. Maternity services. Specialist to Help Birth. ISBN 978-975-491-493-1 115. 2018. Access: www.hips.hacettepe.edu.tr. Access date: 05.09.20.
- Seibold C, Licqurish S, Rolls C, Hopkins F. Corrigendum to ‘‘lending the space': Midwives' perceptions of birth space and clinical risk management’, Midwifery. 2011;27(5):526–531.
- Vural G, Erenel AŞ. Why did medicalization of birth increase, Can we reduce it? Journal of Hacettepe University Faculty of Nursing. 2017;4(2):76-83.
- Elmir R, Pangas J, Dahlen H, Schmied V. A meta-ethnographic synthesis of midwives' and nurses' experiences of adverse labour and birth events. J Clin Nurs. 2017;26(23-24):4184-4200. http://doi: 10.1111/jocn.13965.
- Ulusoy H, Moroğlu Tokgöz D. The views of doctors and nurses on teamwork. Pamukkale Medical Journal. 2009;2(2):55-61.
- Öğüt A, Kaya ŞD. Teamwork in healthcare institutions. Selcuk University Kadinhanı Faik İçil Vocational School Journal of Social and Technical Research. 2011;1(1):87-95.
- DeJoy SA, Sankey HZ, Dickerson AE, Psaltis A, Galli A, Burkman RT. The Evolving Role of Midwives as Laborists. J Midwifery Womens Health. 2015;60(6):674-681. http://doi: 0.1111/jmwh.12350.
- Çelik A, Karaca A. Evaluating the relationship between teamwork and motivation in nurses and affecting factors. Journal of Education and Research in Nursing. 2017;14(4):254-263. http://doi:10.5222/HEAD.2017.254.
- Güleç Şatır D, Ünsal Atan Ş, Taner A, Gün S. Determining the knowledge and opinions of nurses and midwives working in gynecology clinics regarding natural birth and birthing interventions. Journal of Education and Research in Nursing. 2018;15(4):222-227.
- Chen I, Opiyo N, Tavender E, Mortazhejri S, Rader T, Petkovic J, Yogasingam S, Taljaard M, Agarwal S, Laopaiboon M, Wasiak J, Khunpradit S, Lumbiganon P, Gruen RL, Betran AP. (2018). Non-clinical interventions for reducing unnecessary caesarean section. Cochrane Database Syst Rev. 2018;9(9): CD005528. http://doi: 10.1002/14651858.CD005528.pub3.
- Seijmonsbergen-Schermers A, van den Akker T, Beeckman K, Bogaerts A, Barros M, Janssen P, Binfa L, Rydahl E, Frith L, Gross MM, Hálfdánsdóttir B, Daly D, Calleja-Agius J, Gillen P, Vika Nilsen AB, Declercq E, de Jonge A. Variations in childbirth interventions in high-income countries: Protocol for a multinational cross-sectional study. BMJ Open. 2018;8(1):e017993. http://doi: 10.1136/bmjopen-2017-017993.
- Bilgin Z, Ocakçı AF. (2011). The professional motivation of midwifery students. Journal of Anatolia Nursing and Health Sciences. 2011;14(3):40-46.
- Aslan Ş, Okumuş F. (2017). The influence of childbirth expectation on primiparous women’s perceptions of their birth experience. HSP. 2017;4(1):32-40. http://doi: 10.17681/hsp.287497.
- Yapça ÖE, Karaca İ, Çatma T. How can we reduce the increasing primary cesarean rates? Evaluation of our 3-year data of cesarean sections. IKSSTD. 2015;7(3):97-102.
- Karaçam Z. (2016). The state of the midwifery as a professional career in turkey: Legal regulations, education and research. Lokman Hekim Journal. 2016;6(3):128-136.
- Başkaya Y, Sayıner FD. Evidence-Based Midwifery Practices to Reduce Cesarean Rat. HSP. 2018;5(1):113-119. doi:10.17681/hsp.335472