Abstract

The purpose of this study was to investigate the effective midwifery care from pregnancy to postpartum in order to promote evidence-based midwifery practice in improving childbirth satisfaction and breastfeeding. The subjects were one-month postpartum mothers who came to one-month check-up during July to October in 2010. The purpose of the self-administered questionnaire developed by the research group was explained, then provided to mothers who agreed to participate in the survey at 4 hospitals each with more than 300 beds and 1 clinic with more than 500 deliveries annually in Okinawa. The questionnaire was collected on the same day or via postal mail. A total of 540 mothers agreed to complete the survey, and 434 responses were considered valid for this study (valid response rate: 80.4%). Vaginal delivery group was 223 (82.3% with medical intervention rate of 15.2%), and the cesarean section group was 48 (17.7%). The most helpful one-on-one guidance was "nipple care in preparation for breastfeeding" during pregnancy, "encouragement" during delivery, and "Kangaroo (skin-to-skin) care" immediately after the delivery. An Application rate of episiotomy was 65.2% for primiparous women and 30.5% for multiparous women. The rate of perineal laceration enlarged to more than third degree in cases with episiotomy is three times more than the cases with no episiotomy. Additionally, the prevalence of breastfeeding at one-month postpartum was significantly higher in the mothers rooming-in with the baby (76.2%) than mothers in separate room (28.3%). Moreover, 60.3% of the mothers in the complete rooming-in group answered they had not felt difficulty with childcare while it dropped to 46.2% among the mothers in the separate room group.