The Construction And Application Of Continuous Centering Pregnancy In Perinatal Care

【Objective】This report mainly investigates the centering pregnancy service requirements of women during prenatal period and focuses on the understanding of women’s perinatal care in different periods in Haikou City.Objective to establish and implement centering pregnancy service process in perinatal period,and to evaluate the clinical effect of prenatal period centering pregnancy.【Method】1.Investigation on centering pregnancy requirements for women in Haikou CityAccording to the literature review and the discussion of the research group,this study designed the prenatal period centering pregnancy questionnaire in Haikou City,and applied Delphi expert consultation method.Then based on the results of centering pregnancy needs survey of 300 women with natural childbirth experience in Haikou City,six topics with the highest needs were counted,which provided the basis for further centering pregnancy discussion.2.Experimental study on centering pregnancyThe study subjects were selected the pregnant women who were pregnant with regular pregnancy and 30～32 weeks of gestation from July 2020 to December 2020 in a third-class hospital in Hainan Province.In addition,144 subjects applied random methods divided into intervention group and control group with 72 cases in each group.The pregnant women in the control group were given routine prenatal examination,health education in pregnant women’s school,childbirth service in childbirth room and postpartum nursing.On the basis of routine prenatal examination,the intervention group adopted centering pregnancy,and 12 pregnant women with close gestational age were divided into one group.After the establishment of the group,the online We Chat group was established simultaneously.After pregnant women were enrolled into the group,regular offline,face-to-face,and online synchronous seminars were held during pregnancy.The discussion topics mainly include six topics identified in the preliminary survey.During childbirth period,group members will encourage and support pregnant women who are giving birth.After childbirth period,We Chat Group continued to exist for 42 days and provided support,and an online discussion and exchange meeting was held on the 42 nd day after.Finally,the weight gain during pregnancy,self-care ability during pregnancy,cesarean section rate,episiotomy rate,duration of labor,postpartum hemorrhage in 2hours,macrosomia rate,42 days postpartum exclusive breastfeeding rate,neonatal Apgar score,general self-efficacy,postpartum depression degree and other performance results of the two groups were compared.【Result】1.Investigation result on centering pregnancy requirements for women in Haikou CityAfter two rounds of expert consultation,this study successfully consulted 14 experts,and finally formed a questionnaire with 4 dimensions and 26 items.After a survey of 300 pregnant women with childbirth experience in Haikou City,the six topics with the highest demand were obtained,including online and offline discussion,and learning about neonatal changes and daily care among mothers in the group.It also includes methods to promote comfortable childbirth and prevent perineal laceration,signs of labor,prenatal preparation and prenatal abnormalities,self-monitoring and paternity,diet during pregnancy,and pregnancy exercise.Finally,the survey also found that pregnant women with a monthly income of less than1000 CNY per capita have a lower demand for perinatal health care,on the contrary,pregnant women with higher education level have a higher demand for perinatal health care services.2.Experimental study result on centering pregnancy(1)Comparison of Childbirth results between the two groups: There was no significant difference between the intervention group and the control group in the time of labor,the amount of postpartum hemorrhage,the rate of episiotomy(P>0.05).However,the weight gain during pregnancy,overweight rate,cesarean section rate and non-indication cesarean section rate in control group was higher than that in intervention group(P<0.05).(2)Comparison of the results of birth phenomenon between the two groups:There was no significant difference in birth weight,incidence of low birth weight infants and 1 minute Apgar score between the intervention group and the control group(P>0.05),the macrosomia rate in the control group was higher than that in the intervention group(P<0.05).(3)Comparison of breastfeeding between the two groups : The 42 days postpartum exclusive breastfeeding rate in intervention group was higher than that in the control group(P<0.05).(4)Comparison of self-care ability of two groups of pregnant women during pregnancy:Self-care ability coefficient during pregnancy in intervention group was higher than that in control group(P<0.05).(5)Comparison of general self-efficacy between the two groups:general self-efficacy coefficient in intervention group was higher than that in the control group,at waiting for labor and 42 days after childbirth(P<0.05).(6)Comparison of postpartum depression between the two groups:There was no significant difference in the depression coefficient between the intervention group and the control group at 1 week postpartum(P>0.05),but depression coefficient in control group was higher than that in intervention group at 42 days postpartum(P<0.05).【Conclusion】1.This paper constructs a targeted questionnaire of perinatal health care service demand in Haikou City,so as to determine the health care theme in line with the characteristics of pregnant women in Haikou City,and provide the basis for the development of centering pregnancy,which also can provide further reference for the related research of centering pregnancy.2.The implementation of centering pregnancy can effectively improve the ability of self-care during pregnancy,natural childbirth rate,42 days postpartum exclusive breastfeeding rate,general self-efficacy during perinatal period,etc.In addition,it can also reduce the incidence of overweight during pregnancy,cesarean section rate,postpartum depression and macrosomia.Finally,it can improve the initiative of pregnant women to participate in perinatal health care,and their perinatal empowerment,self-evaluation,self-management and self-decision-making ability,and enhance the trust and support of midwives,pregnant women and family members,to promote the development and improvement of perinatal health care.