摘要
本文通过比较不同国家间母婴指标的差异,发现以助产士为主导的助产服务体系有更高的顺产率和母乳喂养率,更低的婴儿死亡和孕产妇死亡。美国是以产科医生主导的服务模式,有最高的人均费用,高达71%的麻醉镇痛率,孕产妇死亡率却持续上升高达19/10万。我国妇幼保健服务属于产科医生主导的模式,低危孕产妇与高危产妇均由产科医生管理。产科医生由于没有足够的时间管理、研究和学习,不规范的操作,例如剃除阴毛、会阴切开术、常规新生儿吸痰、分娩时只能仰卧位(膀胱截石位),容易导致孕妇难产及并发症发生。腹部加压助娩以及催产素、麻醉药的滥用导致母婴风险增加。需建立以助产士为主导的正常分娩模式,下沉到社区、家庭,使分娩回归到自然生理本源。
By comparing differences in maternal and infant indicators among countries,this article found that midwifery-lead delivery systems had higher rates of normal births and breastfeeding,and lower rates of infant and maternal death.The United States is an obstetrician-led service model with the highest per capita cost,up to 71%anesthesia analgesia rate,and a maternal mortality rate that continues to rise as high as 19 per 100000.Maternal care system in China is mainly of obstetric-lead model,with both low-risk and high-risk pregnancies managed by obstetricians.The obstetricians do not have enough time to manage,study and learn,and irregular operations,such as shaving of pubic hair,episiotomy,routine neonatal suctioning,and delivery in supine position(bladder truncation position),can easily lead to obstructed labor and complications in pregnant women.Abdominal pressure to assist delivery and the misuse of Oxytocin and anesthetics lead to increased risk to mother and baby.A midwifey-lead model of normal childbirth needs to be established,reaching down to communities and families to return childbirth to its natural physiological origin.
作者
赵玉梅
孟雪
许晨耘
张宏玉
ZHAO Yumei;MENG Xue;XU Chenyun;ZHANG Hongyu(Sanya Maternal and Child Health Hospital(Sanya Women and Children’s Hospital),Hainan Province,Sanya 572022,China;Qingdao Huikang Nursing Training School,Shandong Province,Qingdao 256600,China;Center of Nursing Quality Management of Hainan,Hainan Province,Haikou 571110,China;Hainan Medical University,Hainan Province,Haikou 571119,China)
出处
《妇儿健康导刊》
2023年第5期133-135,共3页
JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE
基金
海南省卫生健康行业科研项目(22A200149)
海南省高等学校教育教学改革研究项目(Hnjg2020-70)。
