This study aimed to understand the meaning that a midwife uses ultrasonography for a pregnant woman's care in examination.
This was a qualitative descriptive study using an inductive approach five pregnant womenand a practicing midwife of a provincial city participated in this study. Data was collectedat an antenatal health check by means of general participant observation andsemi-structured interview. The descriptive analysis of the data was conducted by confirmingthe meaning a of appropriate to each subject.
The results indicated that the meaning of a midwife had such as “utilization as part of thecare by appreciating a pregnant woman wholly”, “cultivate a self-identity”, “induce interestin the fetus” and “joint ownership of the ultrasound image”

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Object
The purpose of this study is to identify the factors involved in the process of maternal role attainment and the interactions between those factors in preterm mothers.
Subjects
The subjects of this study were seven first-time mothers ranging from 25 to 34 years with a mean of 29.7. The subjects delivered their babies after 29 to 35 gestational weeks. Birthweights ranged from 836-1458 grams. The infants had been home from the NICU 9-16months at the first time of the interviews. All of them did not have serious medical problems, developmental delays at the time of discharge from the NICU.
Methods
The design was descriptive, using a grounded theory approach. Data derived fromsemi-structured interviews was examined by constant comparative analysis after each interviewwas transcribed.
Results
Five categories were identified in the process of maternal role attainment in this study:“Loss of expectati ons that the birth will be normal one”, “Grieving caused by unfulfilled expectation”, “Adaptation to the maternal role ”, “The search for normal ‘parent and baby’ images”, “The development of support networks for maternal role attainment”. The finding categories, “Grieving caused by unfulfilled expectation”, “Adaptation to the maternal role”, “The search for normal ‘pa rent and baby’ images”, are interacted with each other in the process of maternal role attainment mothers during first year.“The search for normal ‘parent and baby’ images”, which is considered as a core category in this result, includes a series of a coping strategies that eases the negative feelings resulting from having preterm babies. These strategies involve downward comparison, lateral comparison, searching for meaning in times of crisis, and normalization.
Conclusions
These results contribute to the knowledge of maternal role attainment in preterm mothers and suggest the importance of approaches that enhance the mother's ability to use coping strategies.

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The objective of this study was the revision of Likert scale, a system for measuring thedegree of positive feelings held by new mothers as they adapt to the reordering of their livesto concentrate on taking care of their infants. The revision of the scale consisted of reducingthe number of questions to which the subjects must respond and defining the decisive characteristicsof the subjects with greater clarity.
Sixteen new questions were added to the Likert scale questionnaire, which asked 28 questionsabout child-care life in 3 categories (parental role, everyday stress and positive feelingstoward infant and self), offering 9 possible response selections to each. The questionnaireswere distributed to 321 women who had given birth at one of two general hospitals in Tokyo and come in for their examinations at the stage of one month after birth. Using 309valid questionnaires that were recovered, the responses were subjectedto principal compornentanalysis.
This enabled us to edit the Likert scale questionnaire into 19 questions in four categories (parental confidence, self-assurance, adaptiveness and acceptance of the father's supportiveness), offering 5 possible response selections to each. The confidence factors for each category (Cronbach's a) were between 0.63 and 0.80.
The revised scale fulfills its objective of reducing the number of questions about child carewhile clearly identifying the decisive characteristics of the subjects.

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As one way of exploring the pattern of education for midwifery students, this research aims to clarify the way in which midwifery students learn from experienced expert midwives in the delivery setting.
The researcher's informants comprised 4 midwifery students undergoing practical training in the Delivery Unit of a general hospital in Tokyo. After assisting with delivery care, they talked freely about what they had learned from the expert midwife.
The interview data was recorded and qualitatively analyzed with regard to the learning content and the learning process in which the students had participated.
“How to utilize oneself for care” was chosen as the main theme that characterized the stu-dent learning. This main theme was seen as being composed of three sub-themes:
1. Respecting a woman in labor (as a first priority, coming to grips with the individual existence of the woman in labor, and interacting with her progress during labor).
2. Connecting in such a way as to draw out the ability of the woman in labor (diverting her attention at moments of stress, and grasping the full emotional undertones of her words).
3. Adjusting oneself to the woman in labor (ensuing firstly that one's own feelings are calm and settled, and then monitoring the condition of the woman in labor while continuing to control one's own actions)
In the context of providing care suited to the individual conditions of the women in labor, the midwifery students were able to understand the importance of utilizing themselves for care, but even so, they found it hard to apply this principle in practice.
It follows that in the education and guidance given to midwifery students, it is important to confirm what they have learned from expert midwives in terms of knowledge content and experience, and to devise techniques and forms of advice that deepen students' awareness of the significance of this learning process.

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The purpose of this study was to examine the occurrence of perineal lacerations in birthing homes run by Japanese midwives who are not legally allowed to perform episiotomies by law.
In this cross-sectional study, 71 women who gave normal births at a particular birthing home were interviewed based on a structured questionnaire.
Thirteen women (18.3%) had perineal lacerations while 58 (81.7%) had no perineal injuries. Amongst the injured group, all cases were first-degree lacerations ; no third-and fourth-degree lacerations were observed. On average, the disappearance of laceration pain took 4.8 days. Even with minor lacerations, the women reported feeling safe and did not feel uncomfortable. Furthermore, a lower incidence of perineal laceration was found amongst women who decided the birthing position by themselves compared with those who did not (P=0.03). Finally, perineal laceration appeared to occur less among women who were able to be recognize the lengthening of their perinea near birth, although this study was not large enough to make a stastical conclusion.
This study suggests that it is important for women giving birth to be aware of their bod ily condition near birth and to actively participate in the process of choosing their labor and delivery positions to lower the incidence of perineal lacerations. Support should be given to women so that they become aware of their bodily changes. In addition, obstetricians in most Japanese hospitals routinely perform episiotomies for “the prevention of third-and fourthdegree lacerations”, even though scientific evidence does not support the practice. This study presented, however, it is possible to undergo childbirth without episiotomies or high-degree perineal lacerations.

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