Study On The Effects Of Midwives’Antenatal Clinic Service On Primiparas’ Childbirth Outcomes

Objective:(1)To explore the effect of midwives’antenatal clinic service on primiparas’birth outcomes.(2) To describe the primigravidas experience of receiving the midwives’antenatal clinic service.Methods:The study was carried out in two phases, using combined with qualitative and quantitative research method. Participants for each phase were enrolled at Shanghai Gynecology and Obstetrics hospital. A quantitative research design was adopted in the first phase. Randomize participants from obstetric department of Fudan University into two groups, experimental group (55samples) and control group (55samples),110samples totally. Participants in two groups have no statistically differences in age, education background, occupation, biparietel diameter value and pelvic value (p>0.05). Primiparas in control group only received regular antenatal clinic, while primiparas in experimental group received both regular antenatal clinic services and midwives’antenatal clinic, including the built relationship between midwives and pregnant women and their family members during pregnancy, individualized birth plan, guidance for every pregnant women individually and so on. The evaluation indicators include the caesarean section rate between the experimental group and control group, the duration time of the first, second, third and overall stage of labor,2hours postpartum hemorrhage, neonatal Apgar scores of1and5minutes after birth, neonatal weight, anxiety score before and after birth and satisfaction rate. SPSS16.0was used to analyze data to descript through percentage and average value, and caesarean section rate, duration of stage of labor and postpartum hemorrhage were analyzed by t test, chi-square test and Mann-Whitney U test. The second phase was qualitative study, data was collected using in-depth interviews with11patients who had received the midwives’antenatal clinic service. Phenomenological method was used to analyze the data.Results:(1) The number of natural birth in experimental group is statistically higher than those in control group (P<0.05);(2) No statistically differences in2hours postpartum hemorrhage, neonatal Apgar scores of1and5minutes after birth, neonatal weight between two groups (P>0.05), and5-minutes-postpartum Apgar scores of all neonates in two groups were9.(3) The duration time of the first, second, third and overall stages of labor between two groups were no different (P>0.05).(4) The anxiety score between before the clinic and before labor in control group has difference (P<0.05); while the score for experimental group has no statistically difference(P>0.05).(5) After intervention, antenatal satisfaction and perinatal experience satisfaction between the two groups stated statistically difference.(6) The core themes of experience whose participating midwives’antenatal clinic were focusing on mental construction, the advantage of midwives’antenatal clinic, increasing the ability of handling labor and the change of labor methods.Conclusion:(1) Midwives’antenatal clinic service could decrease rate of cesarean section and increase rate of natural birth;(2) Midwives’antenatal clinic service could improve perinatal satisfaction and positive experience;(3) Midwives’antenatal clinic service could enhance the parturient ability to handle the labor process and adapt the whole perinatal process, family members’participating could also increase parturient s’social support.