Effect Of Midwife-led Service On Primiparas’ Perinatal Self-efficacy,Childbirth Outcomes And Midwives’ Working Experience

Objective:1.To explore the effect of midwife-led delivery service on primiparas’ perinatal self-efficacy and childbirth coping behavior.2.To explore the effect of midwife-led delivery service on primiparas’ childbirth outcomes.3.To explore ways of improving primiparas’ perinatal self-efficacy.4.To explore the strengths and weaknesses of midwife-led delivery service,which contributes to its sustainable development.Methods:1.The research adopted quantitative and qualitative analysis methods,which explored the impaction of midwife-led delivery service on primiparas’ perinatal self-efficacy,childbirth outcomes and midwives’ work experience.2.The first part of this research was observational study.The primiparas were given birth form September in 2014 to March in 2015.The primiparas in the observation group received midwife-led delivery service.The primiparas in the control group received routine delivery service.In this research,the CBSEI-C32 and CCB were applied to assess primiparas’ perinatal self-efficacy.Childbirth outcomes were selected as objective indicators.The data were analyzed by SPSS20.0 statistical software.3.The primiparas’ childbirth self-efficacy,their childbirth coping behavior,the rate of cesarean section,episiotomy and labor analgesia,stage of labor,birth weight and volume of bleeding 2 hours postpartum were measured and compared between the two groups.4.The second part of this research was qualitative study.5 midwives were interviewed.The interviews were analyzed by phenomenological methodology.Results:1.No statistic difference was observed in age,gravidity,abortion,culture level and professional between the observation group and the control group(P>0.05).2.The post research scores of childbirth self-efficacy in the observation group were significantly higher than these of the control group(P < 0.01).The self pre and post research scores of childbirth self-efficacy in two groups were analyzed.In the observation group,the scores of childbirth self-efficacy in the post research were significantly higher than these of the pre research(P<0.01).3.The scores of childbirth coping behavior in the observation group were significantly higher than these of the control group(P<0.01).4.The first stage of labor,the second stage of labor,the total labor time and volume of bleeding 2 hours postpartum in the observation group were significantly lower than these of the control group(P<0.05).The rate of cesarean section and labor analgesia in the observation group were significantly lower than these of the control group(P<0.01).There were no significant differences in the third stage of labor,the rate of episiotomy and birth weight between the two groups(P>0.05).5.Midwives’ work experience could be classified into these following themes:(1)positive experience : respect and identification of midwifery,strengthening clinical thinking.(2)negative experience : professional pressure and risk,physical and mental sub-health,negative impaction on family and social life.(3)advices for midwife-led delivery service.Conclusions:1.Midwife-led delivery service has good effects on primiparas’ perinatal self-efficacy and childbirth coping behavior,improves birth outcomes,decreases medical intervention and provides them positive experience of natural delivery.2.Midwife-led delivery service has good effects on midwives’ clinical thinking.They have received respect and gained negative physical and mental changes when providing midwife-led delivery service to primiparas.3.Midwife-led delivery service has its outstanding features and shortcomings.How to develop the model is next research orientation.