40歳以上の初産婦に対して経験10年以上の助産師が行っている産褥期のケア

Postpartum Care Provided by Midwives with over 10 Years of Experience for Primiparas Aged over 40

要旨

　目的：40歳以上の初産婦に対して助産師が行っている産褥期のケアを明らかにすること．

　方法：助産師経験10年以上の助産師9名を対象に，半構造化面接にてデータを収集し，質的記述的に分析した．

　結果：助産師は，【長年かけて築いた生活が変わることを継続して意識づける】，【褥婦の体力やペースに合わせ，育児を継続できるようにかかわる】，【褥婦が育児方法を納得でき，自らSOSを出せるようにかかわる】というケアを行なっていた．なかには他者の判断を優先して生きてきた褥婦もいるため，その傾向を見極めながら【他者の判断を優先して生きてきた褥婦が，自分の判断で育児できるようにかかわる】というケアを行なっていた．また，【サポートを得にくい褥婦が一人で頑張らないような支援体制を作る】というケアを行っていた．

　結論：助産師は，40歳以上の初産婦に対して40歳以上の初産婦の人生経験や価値観を尊重したケアを行なっていることが明らかになった．

　Purpose: This study aimed to clarify postpartum care provided by midwives for primiparas aged over 40.

　Methods: Data were collected through semi-structured interviews from 9 midwives with over 10 years of experience and analyzed by qualitatively and descriptively analyzed.

　Results: Midwives provided care [to help primiparas aged over 40 to continuously understand that the lives they had built for a long time would change], [to help primiparas can continuously care for the child, while adapting to the primiparas' pace and physical strength], [to help primiparas be convinced regarding childcare methods and be able to ask for help themselves]. On the other hand, since some primiparas aged over 40 depend on others for decision-making, midwives provided care [to help primiparas who depend on others for decision-making to be able to make decisions on their own and care for the child]. Since many primiparas cannot get sufficient support after leaving the hospital, midwives provided care [to create a support system so that primiparas who cannot get support need not persevere alone].

　Conclusion: This study clarified that midwives provided care that comprises understanding and respecting the sense of values and life experience of primiparas aged over 40.