부산대학교 도서관

The purpose of this study was to establish guidelines for the standardization of clinical practice protocol (CPP) of natural birth management education for midwives by identifying midwives in general hospitals consisting of midwives including midwives and midwives training centers in Korea. This study used a cross-sectional mixed-method design to quantitatively and qualitatively explore clinical practices on natural birth management in Korean women's healthcare hospitals (n=2) having midwives and maternity centers (n=13). For quantitative data analysis, this study used frequency analysis, means and standard deviations using SPSS ver. 23.0. Multiple response questions were analyzed with dichotomies and weight-categories multiple response analysis. Qualitative data analysis was performed using the content on natural birth management among directors of maternity centers by involving data coding of meaning framework on the design and spread of CPP gathered from primary, secondary in-depth interviews based on WHO’s midwives code of conduct. The findings of the quantitative analysis revealed that the appropriate time to commence initial counseling for mothers were 20-24 weeks (53.8%) in maternity centers and 6-12 weeks (100.0%) in hospitals. Moremore, the proper duration of maternal care in the postpartum period was 6 hours (46.2%) after the birth in maternity centers and three days-two nights (100.0%) in hospitals. Hospital transfer accounted for the largest percentage of all emergency cases in the high-risk classification system of pregnant women. Furthermore, the aid of midwives was found to be an essential service required to assist exercise programs in the pre and postnatal periods, healthcare of newborn infants, breast-feeding, and nutritional management in pregnancy, childbirth, newborn care, and family counseling. In the results of the qualitative analysis, the data on CPP analysis were classified into 12 sub-items in major group, 24 sub-items in sub-major group, and 90 sub-items in minor group. In conclusion, the establishment of the guidelines for the standardization of clinical practice protocol for natural birth management in maternity centers is expected to contribute in improving the quality of midwives, maternity centers and childbirth-related health facilities and expanding the educational innovation of domestic maternal and child health programs.