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THE MIDWIFERY MODEL IN CHILE: AN IMPLEMENTATION ASSESSMENT
Author(s) -
Binfa Lorena
Publication year - 2011
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/j.1542-2011.2011.00096.x
Subject(s) - medicine , episiotomy , promotion (chess) , nursing , population , health care , metropolitan area , birth attendant , family medicine , obstetrics , pregnancy , environmental health , maternal health , health services , genetics , pathology , politics , political science , law , economics , biology , economic growth
Professionally trained midwives provide care to approximately 80% of the childbearing population in Chile. Prior to 2007, however, intrapartum care had become medicalized. In 2007, the Chilean Minister of Public Health adopted the Model of Integrated and Humanized Health Services , concurrently with the Clinical Guide for the Humanized Attention of Labour and Delivery . The main objective of this guide is to guarantee access to all pregnant women in Chile adequate professional assistance during labour and delivery, with “a safe, personalized and human delivery.” This attention includes continuous emotional support, reduction of intrapartum continuous fetal monitoring, use of alternative modes of pain relief, promotion of free position change and walking, restriction of episiotomy, elimination of the use of enema and genital shaving, and promotion of mother and newborn early skin‐to‐skin contact. Aims: The aims of this study are 1) to explore perceptions of this humanized attention during labour and delivery by both the professional staff (obstetricians and midwives) and consumers; 2) to identify the degree of maternal‐newborn well‐being; and 3) to describe selected obstetric outcomes of the women enrolled in the study who received care within this model. Methods : A cross‐sectional, descriptive study conducted of 450 women who gave birth in 2 major hospitals within the National Health System in the Metropolitan Area, Santiago, Chile, from September 2010 until June 2011. Qualitative methods include focus groups of midwives, obstetricians, and consumers. Quantitative methods include a validated survey of maternal well‐being and an adaptation of the American College of Nurse‐Midwives’ standardized antepartum and intrapartum data set. Results: Preliminary results show that 98% of births used oxytocin, 88% used continuous monitoring, 83% used the lithotomy position, and 60% had undergone episiotomy. Conclusions: Medicalization of birth still occurs; no changes have been observed since the implementation of the Clinical Guide for the Humanized Attention of Labor and Delivery in Chile.