Saygılı Annelik Bakımı ve Sürekli Ebelik Desteğı: Ebelerın Rolü ve Sürekli Ebelik Bakım Modelleri
Özet
Bu bölümde, ebelerin sürekli ebelik desteği (SED) ve saygılı annelik bakımı (SAB) uygulamalarındaki rolleri ele alınmıştır. SAB, kadınların gebelik, doğum ve doğum sonrası dönemlerde insan haklarına dayalı, onurlu ve empatik yaklaşımları içeren sağlık hizmeti alma hakkıdır . SED ise ebenin doğum süresince kadına kesintisiz fiziksel, duygusal ve bilgilendirici destek sunmasıdır. Bölümde ayrıca SED ile Sürekli Ebelik Bakım Modelleri (SEBM) arasındaki farklar açıklanmıştır. Araştırmalar, SED’nin SAB göstergelerini güçlendirdiğini; doğumda şiddet ve gereksiz müdahale oranlarını azalttığını; kadının memnuniyetini ve kontrol duygusunu artırdığını göstermektedir. Ebelerin, bu süreçte kadın haklarının savunucusu ve saygılı bakımın uygulayıcısı olarak rolleri tartışılmıştır. Sonuç olarak SAB ve SED birbirini tamamlayan kavramlardır. SED, SAB ilkelerinin sahadaki uygulanabilirliğini artırarak anne ve bebek sağlığı çıktılarının güçlenmesine ve kadınların sağlık sistemine güveninin yükselmesine katkı sunar.
This section examines continuous midwifery support (CMS) and the roles of midwives in respectful maternity care (RMC) practices. RMC is defined as the right of women to receive maternity care that is grounded in human rights, dignity, and empathy throughout pregnancy, childbirth, and the postpartum period. CMS refers to the uninterrupted physical, emotional, and informational support provided by a midwife during labor. The section also clarifies the distinctions between CMS and Continuity of Midwifery Care Models (CMCM). Research indicates that CMS strengthens RMC indicators by reducing instances of abuse and unnecessary interventions while enhancing women’s satisfaction and sense of control during childbirth. The roles of midwives as advocates for women’s rights and implementers of respectful care are emphasized. In conclusion, RMC and CMS are complementary concepts. CMS enables the practical implementation of RMC principles, improving maternal and newborn health outcomes and enhancing women’s trust in the healthcare system.
Referanslar
World Health Organization. WHO recommendations: Intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018.
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, Weston J. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews. 2013;7:CD003766.
Bohren MA, Tunçalp Ö, Miller S. Transforming intrapartum care: Respectful maternity care. Best Practice & Research Clinical Obstetrics and Gynaecology. 2020;67:113-126.
Bowser D, Hill K. Exploring evidence for disrespect and abuse in facility-based childbirth: Report of a landscape analysis. USAID-TRAction Project, Harvard School of Public Health & University Research Co., LLC; 2010.
White Ribbon Alliance. Respectful maternity care: The universal rights of childbearing women. Washington DC: White Ribbon Alliance; 2011.
Miller AS, Skinner J, Maude R. A review of continuity of care for rural and remote women. Canadian Journal of Rural Medicine. 2012;17(1):7-13.
Dhakal S, Lee N, Cheung NF. Midwives' experiences of providing continuity of care in rural settings: A qualitative study. Midwifery. 2022;109:103291.
Homer CSE, Brodie PM, Leap N, Sandall J. Midwifery continuity of care: A practical guide. London: Routledge; 2016.
FIGO. Mother-Baby Friendly Birthing Facilities. London: FIGO; 2021.
Renfrew MJ, McFadden A, Bastos MH, Campbell J, Channon AA, Cheung NF, et al. Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. The Lancet. 2014.
Brodsky PL. Where have all the midwives gone? Journal of Perinatal Education. 2008;17(4):48-51. doi:10.1624/105812408X324912.
Symon A, McFadden A, White M, Fraser K, Cummins A. Using the Quality Maternal and Newborn Care Framework to evaluate women's experiences of different models of care: A qualitative study. Midwifery. 2019;73:26-34.
Homer CSE. Challenging midwifery care, challenging midwives and challenging the system. Women and Birth. 2006;19(3):79-83.
Morgan M, Fenwick N, McKenzie C, Wolfe CD. Quality of midwifery led care: assessing the effects of different models of continuity for women's satisfaction. BMJ Quality & Safety. 1998;7(2).
Page L. One-to-one midwifery: restoring the “with woman” relationship in midwifery. Journal of Midwifery & Women's Health. 2003;48(2):119-125.
Cummins AM, Denney-Wilson E, Homer CSE. The experiences of new graduate midwives working in midwifery continuity of care models in Australia. Midwifery. 2015;31(4):438-444.
Page L, McCourt C, Beake S, Vail A, Hewison J. Clinical interventions and outcomes of one-to-one midwifery practice. Journal of Public Health. 1999;21(3):243-248.
Senate Community Affairs References Committee. Rocking the cradle: a report into childbirth procedures. Canberra: Commonwealth of Australia; 1999.
Hartz DL, Foureur M, Tracy SK. Australian caseload midwifery: The exception or the rule. Women and Birth. 2012;25:39-46.
Williams K, Lago L, Lainchbury A, Eagar K. Mothers’ views of caseload midwifery and the value of continuity of care at an Australian regional hospital. Midwifery. 2010;26(6):615-621.
North Staffordshire Changing Childbirth Research Team. A randomised study of midwifery caseload care and traditional shared-care. Midwifery. 2000;16:295-302.
Collins CT, Fereday J, Pincombe J, Oster C, Turnbull D. An evaluation of the satisfaction of midwives working in midwifery group practice. Midwifery. 2010;26(4):435-441.
McLachlan HL, Forster DA, Davey MA, Farrell T, Gold L, Biro MA, et al. Effects of continuity of care by a primary midwife (caseload midwifery) on caesarean section rates in women of low obstetric risk: the COSMOS randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology. 2012;119(12):1483-1492.
Stevens T. Midwife to midwif: a study of caseload midwifery. Thesis for the degree of Doctor of Philosophy. Thames Valley University; 2002.
Benjamin Y, Walsh D, Taub N. A comparison of partnership caseload midwifery care with conventional team midwifery care: labour and birth outcomes. Midwifery. 2001;17:234-240.
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.
Bohren MA, Mehrtash H, Fawole B, et al. How women are treated during facility-based childbirth in four countries: A cross-sectional study with labour observations and community-based surveys. The Lancet. 2019;394(10210):1750-1763.
International Confederation of Midwives. Essential competencies for midwifery practice. The Hague: ICM; 2019.
Bohren MA, Berger BO, Munthe-Kaas H, Tunçalp Ö. Perceptions and experiences of labour companionship: A qualitative evidence synthesis. Cochrane Database of Systematic Reviews. 2019;3:CD012449.
Musizvingoza R. Kadın sağlığının sosyo-kültürel belirleyicileri: Zimbabve'de 15–49 yaş grubundaki anne adaylarının doğum ve sağlık hizmetleri süreçlerinin incelenmesi. Doktora tezi. Bursa Uludağ Üniversitesi; 2020.
Aktaş S. Doğumdaki ebe sayısı ve ebelerin memnuniyet düzeyi ile annelerin doğum memnuniyeti arasında bir ilişki var mı? Jinekol Obstet Neonatol Tıp Dergisi. 2015;1(1):5-6.
Özcan E, Akdemir A. Bakımda gelişen bir paradigma: saygılı annelik bakımı. Kadın Sağlığı Hemşireliği Dergisi. 2023;9(Özel Sayı-1):56-61.
Kaçar N. Ebe tarafından verilen sürekli doğum desteğinin mesleki ve obstetrik sonuçlara etkisi. Journal of Midwifery and Health Sciences. 2020;3(3):214-224.
World Health Organization. The prevention and elimination of disrespect and abuse during facility-based childbirth: WHO statement. Geneva: World Health Organization; 2014.
Tracy SK, Welsh A, Hall B, Hartz D, Lainchbury A, Bisits A, et al. Caseload midwifery care versus standard maternity care for women of any risk: M@NGO, a randomized controlled trial. Lancet. 2013;382(9906):1723-1732.
Homer CSE, Leap N, Edwards N, Sandall J. Midwifery continuity of care in an area of high socioeconomic disadvantage in Australia: a retrospective analysis. BMC Pregnancy Childbirth. 2017;17(1):303.
Rowley MJ, Hensley MJ, Brinsmead MW, Wlodarczyk JH. Continuity of care by a midwife team versus routine care during pregnancy and birth: a randomised trial. Med J Aust. 1995;163(6):289-293.