This study examined contents of verbal behaviors by women and midwives during labor and delivery and the relationship between verbal behavior by midwives and womens' subjective experiences.
Sixteen healthy primigravidous women participated in this study. We observed intrapartum interactions between women and midwives while recording them on videotape and conducted a questionnaire three days after birth. As a result, we found two-way verbal behaviors in the first stage of labor more frequently than the second stage. Then the verbal behavior which has significant correlation with the womens' score of self-evaluation of measures and feelings of accomplishment in labor and delivery was frequencies per 5 minutes of midwives' verbal behavior of acceptance and agreement in the first stage of labor, and was frequencies per 5 minutes of womens' verbal behavior of acceptance and agreement in the second stage. Therefore we found that the first stage of labor was important for establishing relationship between women and midwives because of frequent verbal interactions. Then, it was suggested that continuous acceptance and agreement through labor and delivery had positive effects for self-evaluation of measures and feelings of accomplishment in labor and delivery.

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Alterations of the birth canal at the pelvic outlet during natural delivery were mechanically analyzed. From this, three propositions were derived as follows.
1) When an expulsive force during delivery operates on the center of the vaginal opening, its line of force agrees with the pelvic axis. If the force causes the least alterations of the birth canal at the pelvic outlet, some lacerations are not liable to occur. Under continuous observation on the alterations of the vaginal opening, the mark and direction of the expulsive force can be estimated previously. Therefore, the lacerations would be prevented by means of adjusting the direction of the force.
2) If a woman in delivery make her drive angle narrower on her fetal head expulsion, she is easy to fit the direction of the expulsive force to her pelvic axis and she may be relieved of some lacerations. Therefore, the lacerations would be prevented by making the drive angle narrower; flexing the thighs and/or leaning forward.
3) If a muscular resistance is weaker at the pelvic floor, the expulsive force tends to sift forward, whereas if the resistance is stronger there, the force backward. In the latter case, the perineal lacerations are liable to occur. Since a woman in pregnancy or delivery is adviced and trained soften the tissue of her birth canal, she can lower the power of resistance of the perineal mucles by herself; this leads to the prevention of perineal lacerations.
Based on the analysis of the Japanese midwifery method from the abovementioned viewpoints, the significance of the midwives' professional techniques could be elucidated materially and theoretically.

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[in Japanese]

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