Abstract
Purpose
The present study aims to make a sampling of the factors constituting the observation viewpoints by midwives in the community who are well versed in breastfeeding during lactation period, and thus to clarify the characteristics of their viewpoints.
Methods
The study was carried out at a midwife clinic specializing in breastfeeding support, a hospital and a maternity center in Japan. The subjects for this study were 6 midwives, and 25 postnatal women who received the breastfeeding care by the midwives for the first time were employed as the study collaborators. We conducted the semi-structured interviews with the subjects after making observations at breastfeeding care for the study collaborators, and made a sampling from the data collected that were deemed to be the "observations by midwives". Then we compared our categorized data with those in the literature.
Results
The observation factors for assessing breastfeeding care by midwives for the postnatal women and the children were composed of the 3 categories, i.e. "Mother", "Child" and "Mother and Child". In comparison with the previous studies, the category of "Mother" was found to additionally contain the sub-categories of "Behavior Characteristics", "Reflection" and "Image" as the indicators of psychological state, and the sub-categories of "Clothes", "Lifestyle" and "Medical support" as the indicators of social state. The sub-category of "Behavior characteristics" indicated the women's behavior based on their cultural values. The "Child category" was newly sub-divided into "Power" and "Follow-up". Also in the category of "Mother and Child", the sub-category of "Event" was newly added in the present study. As the observation characteristics by midwives, the observation factors attaching great importance to specific and individualized aspects of the environment or life surrounding a mother and child were taken as a sample. Among such observation factors, especially the observation factor of midwives evaluating the conditions of breasts by touching them using their own hands was taken as a sample. Furthermore, as the characteristics of the observation viewpoints by midwives, these were constructed on not only the respective viewpoints of "Mother" and "Child", but also the viewpoint of the dyad of "Mother and Child".
Conclusion
It was found that, in breastfeeding care, midwives observed multi-facedly the detailed information closely related to the life of a mother and child during the lactation period, examining directly the breast conditions by their own hands. Moreover, their observations characteristically consisted of not only the respective viewpoints of "Mother" and "Child", but also the viewpoint of the dyad of "Mother and Child".
