Purpose
The purpose of this study was to identify factors related to the decision-making on stages of labor done by midwives in practice.
Method
The subjects of this study were eight midwives in practice who had 14.6-year clinical experience on the average. The data were collected using semi-structured interviews andrecorded with participant's consent. They talked freely about how they had assessed the cli-ent and provided care during one normal delivery. Aftereach interview was transcribed, the data were compiled and then analyzed qualitatively using a grounded theory approach.
Results
As a result, seven factors were extracted from the data as follows:
1) judging the normalcy of the labor and it's progress, 2) respecting and understanding toward the woman's desires, 3) assuring the woman's self-determination, 4) providing appropriate care for the family to keep its balance, 5) providing physical and psychological care for the woman, 6) identifying the woman's anxiety about potential risk and reassuring thesafety of the mother and the baby, and 7) integrating midwives' beliefs with knowledge.
Conclusion
Belief in respect for natural and daily rhythm on delivery was a basis for the midwife's decision-making. They provided a support based on such belief integrated with sophisticated knowledge through advanced experience.

View full abstract

Procedure
I had interviewed 18 women soon after their delivery. During the interview, their descriptions of labor and delivery were recorded. Those descriptions were analyzed qualitatively.
Result
Women who have had a natural birth report that they seemed to be able to control their labor and felt a strong bond with the baby. By feeling the baby's existence during the birth process, unimpeded by unnecessary medical assistance or drugs, they were able to have confidence in the newborn's health and also could feel a special closeness to the newborn as a result of consecutive process from conception to labor and delivery. Additionally, by getting over the pain of labor and delivery, the women were able to feel a sense of achievement and satisfaction and could truly realize the power of giving birth. Those emotions, feeling the baby's existence in birth canal, drove the women accept themselves and babies as they are, and enriched the women's emotions.
Conclusion
Some women could sense their fetus pass through the birth canal during labor and those women could feel their emotion were truly enriched. We have to take it as a very important process for women to feel baby's existence throughout labor. Key Words Experience of women in labor, The birth canal

View full abstract

Purpose
The purpose of this research is to shed light on how nursing practices support the role of partners of high-risk pregnancies (HRP). Partners of HRP are often ambivalent about their roles and responsibilities. They not only have an important role in the economic support of their partners, but they are also expected to be the key-person in her psychological support system.
Method
Semi-structured interviews were conducted with 21 nurses who care for HRP at two hospitals in Hiroshima Prefecture. Content analysis was done on 272 incidents of nursing support and care for the partners of HRP.
Results
Data used was not solely restricted to incidents where nursing staff had direct contact with partners of HRP. With respect to the role of partners, nursing care was divided into 6 classifications;“creating a relationship”, “assessing partners competency”, “providing appropriate information”, “spatial and temporal considerations”, “support role education”, and “partner response”. It was assumed that each of these care classifications contained a positive intervention aspect, and a response intervention aspect.
Conclusion
It has become clear that the 6 classifications of care proposed in this research can be observed in the care partners of HRP receive.? It is hoped that nursing staff will realize the importance of observing the responses of artners of HRP.

View full abstract

Purpose This research aims to describe what woman in families of procreation had to say about the changes in family dynamics as the result of the birth of a second child, in order to explore the formation of a family of four.
Method This is a prospective exploratory descriptive study based on field research. Seven women, each with a child aged 30-36 months and expecting a second child, were interviewed in the survey. Semi-structured interviews were conducted at their homes on three separate occasions: towards the end of pregnancy, and at two and six months' postpartum. This research is an attempt to describe their family lives while highlighting three aspects: 1) the family as a unit ; 2) the interrelationship in family members ; and 3) the interrelationship between the family and the external world.Results The central theme was the formation of a family of four while considering the development of the first child'. The interviewees said that towards the end of their pregnancy, they spent their lives worrying about their firstborn rather than about the baby in the womb, despite already being a family of four. Two months following childbirth, complaints were expressed about the dysfunction in interrelationship in family members: mother-and-children, and husband-and-wife. However, the women later reported that, at about three months after the birth of the second child, their firstborn had begun to act more like an older sibling, and the husband more like a father. Six months' postpartum, the family life of the four started to establish itself and the new family unit commenced communication with the outside world. At this stage, the families entered into a stable situation in which the women were able to view day-to-day life without stress.
Conclusion The results from the research have shown the process of restructuring a family of three into a family of four. It is a process in which family dynamics change and interact as exchanges start to take place between the family and the community and families of origin ; the family thus becomes transformed into a stable unit.

View full abstract

Thank you very much for the honor of being invited to speak before you today at the 17th Japan Academy of Midwifery. It is a special honor for me because I am not a midwife or maternal-child nurse. My specialty is Gerontological nursing. However, despite our differences, we have much more in common than not. We are all nurses and this unites us.

View full abstract