A survey of care policies for low risk pregnancies among obstetric institutions in Japan
Article ID: JJAM-2019-0025
Details
Article ID: JJAM-2019-0025
Objectives
The Japan Academy of Midwifery published “2016 Evidence-based Guidelines for Midwifery Care” (hereinafter, this is called “2016 Guidelines”). The objective of this study was to search and clarify about maternity care policies based on 2016 Guidelines among Obstetric Institutions in Japan.
Methods
The participants of this survey were 3164 institutions; hospitals, clinics, and midwifery birth centers in Japan. This study was self-administered anonymously questionnaire survey and was conducted with mail or web surveys. The questionnaire included 11 maternity care policies that based on “2016 Guidelines”. Data was collected through November to December 2016. The ethics committee of St. Luke's International University, Tokyo, Japan (No.16-A062) provided ethical approval.
Results
362 institutions participated in the study (the response rate, 80.4%). Few institutions recommended or provided “Folic acid supplementation” (8.3%), “Screening for domestic violence” (6.9%) and “Antenatal perineal massage” (10.6%). Supplementation in pregnancy; Many institutions did not recommend “Vitamin supplementation” (60.1%) for pregnant women. Conversely, “Iron supplementation” was common (66.1%). The health guidance for discomforts in pregnancy; “Foot bath for leg edema” (74.9%), “Massage for leg edema” (78.4%), “Exercise for low back and pelvic pain” (92.5%) and “Taking dietary fibers for constipation” (96.1%) ware very common at each institutions. The health guidance of taking luxury grocery items; About half of the institutions provided “Health guidance for taking alcohols” (52.6%), but “Health guidance for taking caffeins” were provided still 29.0%.
There was significant difference about “Antenatal perineal massage” (χ2: 8.870, OR: 1.385, 95%CI: 1.129-1.699, p=0.003) whether institutions provided midwifery care in ambulatory or not.
Conclusion
Our results demonstrated that there were some gaps between evidence and clinical practice about maternity care in Japan. This study suggested that necessity of diffusion about “2016 Guidelines” and evidence of maternity care.
