DÜNYA SAĞLIK ÖRGÜTÜ’NÜN OLUMLU DOĞUM DENEYİMİ ÖNERİLERİNİN SAĞLIK PROFESYONELLERİ TARAFINDAN ÇALIŞTIKLARI BİRİMDE UYGULANMA DURUMU
Öz
Amaç: Bu çalışmada, Dünya Sağlık Örgütü’nün olumlu doğum deneyimine yönelik önerilerinin sağlık profesyonelleri tarafından çalıştıkları birimde uygulanma durumunun tanımlanması amaçlanmıştır.
Gereç ve Yöntem: Tanımlayıcı türde 1 Ağustos 2021-1 Şubat 2022 tarihleri arasında yapılan araştırmanın evrenini bir kadın hastalıkları ve doğum dal hastanesi doğum salonunda çalışan veya son bir yılda çalışmış olan sağlık profesyonelleri (82 hekim, 68 hemşire-ebe) oluşturmuştur. Veri toplama formu sosyo demografik özellikler ve Dünya Sağlık Örgütü’nün olumlu doğum deneyimi önerileri temel alınarak oluşturulan sorulardan oluşturulmuştur. Verilerin değerlendirilmesinde; tanımlayıcı istatistik (sayı, yüzde, ortalama ve standart sapma) ve ki kare testi kullanılmıştır. Sonuçlar %95 güven aralığında, p<0,05 anlamlılık düzeyinde değerlendirilmiştir.
Bulgular: Katılımcıların yaş ortalaması 28,82±5,86 yıldır. Saygılı anne bakımı önerilerinden mahremiyeti sağlama (%64,0), gebeye açıklayıcı bilgilendirme (%75,3), ekip ile etkili iletişim kurarak hizmet verilmesinin (%76,0) sağlandığı bildirilmiştir. Farmakolojik olmayan yöntemlerden gevşeme teknikleri uygulandığı (%41,3) ve hareket özgürlüğü sağlandığı (%61,3) belirtilmiştir. Katılımcıların %52,3’ü 4 cm servikal dilatasyonu doğumun birinci evresinin aktif fazını tanımlamanın ölçüsü olduğunu ve vajinal muayene sıklığının %59,3 oranında iki saat ara ile uygulandığını belirtmişlerdir.
Sonuç: Çalışma sonucunda saygılı annelik bakımı uygulamaları, gevşeme ve farmakolojik olmayan ağrı giderme tekniklerinin uygulandığı, Dünya Sağlık Örgütü tarafından önerilmeyen müdahalelerin uygulanma oranı düşük olması ile birlikte halen uygulandığı saptanmıştır. Saygılı annelik bakımı ve farmakolojik olmayan uygulamaların artırılması, doğum evrelerinde gereksiz tıbbi müdahalelerin azaltılması yönünde sağlık profesyonellerinde farkındalık oluşturulmalıdır.
Anahtar Kelimeler
Doğum Anne bakım modelleri Tıbbi müdahale olumlu doğum deneyimi Saygılı anne bakımı
Destekleyen Kurum
yoktur
Teşekkür
Doğum salonu çalışanlarına çalışmaya katkılarından dolayı teşekkür ederiz.
Kaynakça
- 1. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018. [updated 2018; cited 10 July 2020]. Available from: https://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf?sequence=1.
- 2. WHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee. Geneva: World Health Organization; 2017. [updated 2 May 2017; cited 10 July 2020]. Available from: https://www.who.int/publications/i/item/WHO-MCA-17.10
- 3. Oladapo OT, Tunçalp O, Bonet M, Lawrie TA, Portela A, Downe S, Gülmezoglu AM. WHO model of intrapartum care for a positive childbirth experience: transforming care of women and babies for improved health and wellbeing. BJOG 2018;125:918-922. doi:10.1111/1471- 0528.15237.
- 4. Yıldız H. Pozitif doğum deneyimi için intrapartum bakım modeli: Dünya sağlık örgütü önerileri. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 2019;5(2):98-105.
- 5. Sağlık Bakanlığı Halk Sağlığı genel Müdürlüğü. Anne Dostu Hastane Programı. [updated 2017; cited 15 July 2021]. Available from: https://hsgm.saglik.gov.tr/tr/kadin-ve-ureme-sagligi-programlari/anne-dostu-hastaneprogram%C4%B1.html.
- 6. DeKeyser FG, Wruble AW, Margalith I. Patients voice issues of dress and address. Holist Nurs Pract 2003;17:290–4.
- 7. Dahlberg U, Persen J, Skogås AK, Selboe ST, Torvik HM, Aune I. How can midwives promote a normal birth and a positive birth experience? The experience of first-time Norwegian mothers. Sex Reprod Healthc. 2016 Mar;7:2-7. doi: 10.1016/j.srhc.2015.08.001.
- 8. Ulli S. Huber, Jane Sandall, A qualitative exploration of the creation of calm in a continuity of carer model of maternity care in London, Midwifery, 2009; 25 (6): 613-21.
- 9. Ayers S, Bond R, Bertullies S, Wijma K. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychological Medicine. 2016;46:1121-34. https://doi.org/10.1016/j.midw.2007.10.011.
- 10. Hauck Y, Fenwick J, Downie J, Butt J. The influence of childbirth expectations of Western Australian women's perceptions of their birth experience. Midwifery. 2007;23:235-47.
- 11. Mannava P, Durrant K, Fisher J, Chersich M, Luchters S. Attitudes and behaviours of maternal health care providers in interactions with clients: a systematic review. Globalization and Health. 2015;11:36. DOI 10.1186/s12992-015-0117-9.
- 12. Kaya T, İldan Çalım S, Uçan G. Doğum Eyleminde Ebelerle İletişimin Doğum Deneyimine Etkisi. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2021;18(1): 671-7.
- 13. Priddis H, Dahlen H, Schmied V. What are the facilitators, inhibitors andimplications of birth positioning? A review of the literatüre, Women and Birth, 2012,;25(3):100-6. doi:10.1016/j.wombi.2011.05.001.
- 14. Karataş Baran G. Travayda doğum topu kullanımının doğum sürecine etkisi. Ankara Yıldırım Beyazıt Üniversitesi, Sağlık Bilimleri Enstitüsü, Doktora tezi, 2021. Ankara
- 15. Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Systematic Reviews 2016; 28(4). doi: 10.1002/14651858.CD004667.pub5.
- 16. Natalie Van der Gucht, Kiara Lewis, Women׳s experiences of coping with pain during childbirth: A critical review of qualitative research, Midwifery 2015;31(3):349-358.
- 17. Leap N, Sandall J, Buckland S, Huber U, Journey to Confidence: Women's Experiences of Pain in Labour and Relational Continuity of Care,Journal of Midwifery & Women's Health 2010;55(3):234-42.
- 18. Dahlberg U, Persen J, Skogås AK, Selboe ST, Torvik HM, Aune I. How can midwives promote a normal birth and a positive birth experience? The experience of first-time Norwegian mothers. Sex Reprod Healthc. 2016 Mar;7:2-7. doi: 10.1016/j.srhc.2015.08.001.
- 19. Bakan AB, Yıldız M. An Investigation of the Relationship Between Intercultural Sensitivity and Religious Orientation Among Nurses. Journal of Religion and Health 2020; 0123456789. Doi: https://doi.org/10.1007/s10943-020-01007-6.
- 20. Çakır Koçak Y, Sevil Ü. Kadın Doğum Kliniklerinde Yatan Hastalara Kültürlerarası Yaklaşım. Turkiye Klinikleri J Public Health Nurs-Special Topics 2015; 1(3): 52–61.
- 21. Berghella V, Baxter JK, Chauhan SP. Evidence-based labor and delivery management. American Journal of Obstetrics & Gynecology 2008; 199 (5), 445-54. doi:10.1016/j.ajog.2008.06.093.
- 22. Uzel Gökdemir H, Yanıkkerem E. İntapartum dönemde kanıta dayalı uygulamalar: Doğum yapan kadınların tercihleri. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi 2018;11(1):26-34.
- 23. Bingöl FB, Bal MD, Esencan TY, Karakoç A, Küçükoğlu S, Çiftçi R, Mutlu E, Arı Z. Doğum Sürecinde Gebelere Verilen Fiziksel Desteğin Doğum Sonuçlarına EtkisininDeğerlendirilmesi. Journal of Nursing Research 2020; 6(3): 506-13. doi: 10.5222/jaren.2020.52724.
- 24. Lothian JA. Promoting Optimal Care in Childbirth. The Journal of Perinatal Education, 2014;23(4):174-7. doi:10.1891/1058-1243.23.4.174.
- 25. Willmott L. (2014). El Parto es Nuestro (Birth is ours) presents the final report of the campaign "Stop Kristeller: a matter of gravity. [updated 2014; cited 15 April 2020]. Available from: https://www.elpartoesnuestro.es/blog/2014/07/01/el-parto-es-nuestro-birth-ours-presents-final-report-campaign-stop-kristeller-matter-gravity.
- 26. Hutton EK, Hassan ES. Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials. JAMA 2007;297(11):1241-52.
- 27. McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term yenidoğans on maternal and neonatal outcomes. Cochrane Database Syst Rev 2013;7:CD004074.
- 28. Bhatt S, Alison BJ, Wallace EM, Crossley KJ, Gill AW, Kluckow M, te Pas AB, Morley CJ, Polglase GR, Hooper SB. Delaying cord clamping until ventilation onset improves cardiovascular function at birth in preterm lambs. J Physiol 2013;591:2113–26.
- 29. World Health Organization. Delayed clamping of the umbilical cord to reduce infant anaemia. [updated 2013; cited 10 April 2018]. Available from: http://apps.who.int/iris/bitstream/10665/120074/1/WHO_RHR_14.19_eng.pdf. 30. American Pediatrt Academy. Neonatal Resuscıtatıon Program. 7TH EDITION [updated 2015; cited 2 March 2018]. Available from: http://alsrc.org/wordpress/wp-content/uploads/2017/07/NRP-2015-7th-ED-UPDATE_-04-2017-Claudia-Reed.pdf
- 31. Royal College of Obstetricians and Gynaecologists. [updated 2015; cited 2 March 2018]. Available from: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/sip14/
- 32. American College of Nurse Midwives. Delayed umbilical cord clamping. Position Stawtement. Silver Spring (MD): ACNM. [updated 2014; cited 2 March 2018]. Available from: http://www.midwife.org/ACNM/files/ACNMLibraryData/UPLOADFILENAME/000000000290/Delayed-Umbilical-Cord-Clamping-May-2014.pdf
- 33. The American College Of Obstetricians and Gynecologists Committee Opinion. Timing of umbilical cord clamping after birth. The American College Of Obstetricians and Gynecologists Women’s Health Care Phsycians 2014;453(1):1-5.
- .34. Türk Neonatoloji Derneği Doğum Salonu Yönetimi Rehberi. [updated 2016; 2 March 2018]. Available from: http://www.neonatology.org.tr/wcontent/uploads/2016/12/dogum_odasi_yonetimi.pdf.
- 35. Yerlikaya A, İldan Çalım S. Erken Ten Tene Temasın Anne ve Yenidoğan Sağlığına Etkisi: Sistematik Derleme. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 2021;24(1):117-30. DOI: 10.17049/ataunihem.631562.
- 36. Ahi S, Borlu A, Balcı E, Günay O. Bebek dostu bir hastanede doğum yapan annelerin doğumdan sonra ilk bir saatte emzirmeye başlama durumları ve ilişkili faktörler. Ahi Evran Medical Journal 2019;3(2):41-7.
- 37. Oygür N, Önal EE, Zenciroğlu A. Turkish Neonatal Society national guideline for the delivery room management. Turk Pediatri Ars 2018; 53(Suppl 1):3-17.
- 38. Foster JP, Dawson JA, Davis PG, Dahlen HG. Routine oro/nasopharyngeal suction versus no suction at birth.Cochrane Database of Systematic Reviews, 2017. doi: 10.1002/14651858.CD010332.pud2.
- 39. Yıkmaz G, Özbek N, Gürakan B. Yenidoğanın Hemorajik Hastalığı. Sürekli Tıp Eğitim Dergisi 2000; https://www.ttb.org.tr/STED/sted0100/st01004.html.
- 40. Darra S. “Normal”, “Natural”, “Good” or “Good Enough” Birth: Examining The Concepts. Nursing Inquiry 2009;16(4):297-305.
- 41. Downe, Susan, ed. Normal childbirth: Evidence and debate. Elsevier Health Sciences, 2008.
IMPLEMENTATION OF THE WORLD HEALTH ORGANIZATION'S POSITIVE BIRTH EXPERIENCE RECOMMENDATIONS BY HEALTH PROFESSIONALS IN THE UNIT WHERE THEY WORK
Öz
Aim: In this study, it is aimed to define the implementation of the World Health Organization's recommendations for positive birth experience by health professionals in the unit they work.
Materials and Methods: The population of the descriptive study, which was conducted between August 1, 2021 and February 1, 2022, consisted of health professionals (82 physicians, 68 nurses-midwives) who worked in the delivery room of a gynecology and obstetrics hospital or worked in the last year. The data collection form was composed of questions based on socio-demographic characteristics and positive birth experience recommendations of the World Health Organization. In the evaluation of the data; descriptive statistics (number, percentage, mean and standard deviation) and chi-square test were used. The results were evaluated at the 95% confidence interval, at the p<0.05 significance level..
Results: The mean age of the participants was 28.82±5.86 years. It has been reported that among respectful maternal care recommendations, providing privacy (64.0%), explanatory information to the pregnant woman (75.3%), and effective communication with the team (76.0%) are provided. Among non-pharmacological methods, it was stated that relaxation techniques were applied (41.3%) and freedom of movement was provided (61.3%). While 52.3% of the participants stated that 4 cm cervical dilatation was the measure of defining the active phase of the first stage of labor, and the frequency of vaginal examination was performed every two hours at a rate of 59.3%.
Conclusion: As a result of the study, it was determined that respectful maternity care practices, relaxation and non-pharmacological pain relief techniques were applied, although the application rate of interventions not recommended by World Health Organization was still low. Awareness of health professionals should be created to increase respectful maternity care and non-pharmacological practices, and to reduce unnecessary medical interventions during birth stages
Anahtar Kelimeler
Birth Maternal care patterns Medical intervention Positive birth experience Respectful maternity care.
Kaynakça
- 1. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018. [updated 2018; cited 10 July 2020]. Available from: https://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf?sequence=1.
- 2. WHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee. Geneva: World Health Organization; 2017. [updated 2 May 2017; cited 10 July 2020]. Available from: https://www.who.int/publications/i/item/WHO-MCA-17.10
- 3. Oladapo OT, Tunçalp O, Bonet M, Lawrie TA, Portela A, Downe S, Gülmezoglu AM. WHO model of intrapartum care for a positive childbirth experience: transforming care of women and babies for improved health and wellbeing. BJOG 2018;125:918-922. doi:10.1111/1471- 0528.15237.
- 4. Yıldız H. Pozitif doğum deneyimi için intrapartum bakım modeli: Dünya sağlık örgütü önerileri. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 2019;5(2):98-105.
- 5. Sağlık Bakanlığı Halk Sağlığı genel Müdürlüğü. Anne Dostu Hastane Programı. [updated 2017; cited 15 July 2021]. Available from: https://hsgm.saglik.gov.tr/tr/kadin-ve-ureme-sagligi-programlari/anne-dostu-hastaneprogram%C4%B1.html.
- 6. DeKeyser FG, Wruble AW, Margalith I. Patients voice issues of dress and address. Holist Nurs Pract 2003;17:290–4.
- 7. Dahlberg U, Persen J, Skogås AK, Selboe ST, Torvik HM, Aune I. How can midwives promote a normal birth and a positive birth experience? The experience of first-time Norwegian mothers. Sex Reprod Healthc. 2016 Mar;7:2-7. doi: 10.1016/j.srhc.2015.08.001.
- 8. Ulli S. Huber, Jane Sandall, A qualitative exploration of the creation of calm in a continuity of carer model of maternity care in London, Midwifery, 2009; 25 (6): 613-21.
- 9. Ayers S, Bond R, Bertullies S, Wijma K. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychological Medicine. 2016;46:1121-34. https://doi.org/10.1016/j.midw.2007.10.011.
- 10. Hauck Y, Fenwick J, Downie J, Butt J. The influence of childbirth expectations of Western Australian women's perceptions of their birth experience. Midwifery. 2007;23:235-47.
- 11. Mannava P, Durrant K, Fisher J, Chersich M, Luchters S. Attitudes and behaviours of maternal health care providers in interactions with clients: a systematic review. Globalization and Health. 2015;11:36. DOI 10.1186/s12992-015-0117-9.
- 12. Kaya T, İldan Çalım S, Uçan G. Doğum Eyleminde Ebelerle İletişimin Doğum Deneyimine Etkisi. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2021;18(1): 671-7.
- 13. Priddis H, Dahlen H, Schmied V. What are the facilitators, inhibitors andimplications of birth positioning? A review of the literatüre, Women and Birth, 2012,;25(3):100-6. doi:10.1016/j.wombi.2011.05.001.
- 14. Karataş Baran G. Travayda doğum topu kullanımının doğum sürecine etkisi. Ankara Yıldırım Beyazıt Üniversitesi, Sağlık Bilimleri Enstitüsü, Doktora tezi, 2021. Ankara
- 15. Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Systematic Reviews 2016; 28(4). doi: 10.1002/14651858.CD004667.pub5.
- 16. Natalie Van der Gucht, Kiara Lewis, Women׳s experiences of coping with pain during childbirth: A critical review of qualitative research, Midwifery 2015;31(3):349-358.
- 17. Leap N, Sandall J, Buckland S, Huber U, Journey to Confidence: Women's Experiences of Pain in Labour and Relational Continuity of Care,Journal of Midwifery & Women's Health 2010;55(3):234-42.
- 18. Dahlberg U, Persen J, Skogås AK, Selboe ST, Torvik HM, Aune I. How can midwives promote a normal birth and a positive birth experience? The experience of first-time Norwegian mothers. Sex Reprod Healthc. 2016 Mar;7:2-7. doi: 10.1016/j.srhc.2015.08.001.
- 19. Bakan AB, Yıldız M. An Investigation of the Relationship Between Intercultural Sensitivity and Religious Orientation Among Nurses. Journal of Religion and Health 2020; 0123456789. Doi: https://doi.org/10.1007/s10943-020-01007-6.
- 20. Çakır Koçak Y, Sevil Ü. Kadın Doğum Kliniklerinde Yatan Hastalara Kültürlerarası Yaklaşım. Turkiye Klinikleri J Public Health Nurs-Special Topics 2015; 1(3): 52–61.
- 21. Berghella V, Baxter JK, Chauhan SP. Evidence-based labor and delivery management. American Journal of Obstetrics & Gynecology 2008; 199 (5), 445-54. doi:10.1016/j.ajog.2008.06.093.
- 22. Uzel Gökdemir H, Yanıkkerem E. İntapartum dönemde kanıta dayalı uygulamalar: Doğum yapan kadınların tercihleri. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi 2018;11(1):26-34.
- 23. Bingöl FB, Bal MD, Esencan TY, Karakoç A, Küçükoğlu S, Çiftçi R, Mutlu E, Arı Z. Doğum Sürecinde Gebelere Verilen Fiziksel Desteğin Doğum Sonuçlarına EtkisininDeğerlendirilmesi. Journal of Nursing Research 2020; 6(3): 506-13. doi: 10.5222/jaren.2020.52724.
- 24. Lothian JA. Promoting Optimal Care in Childbirth. The Journal of Perinatal Education, 2014;23(4):174-7. doi:10.1891/1058-1243.23.4.174.
- 25. Willmott L. (2014). El Parto es Nuestro (Birth is ours) presents the final report of the campaign "Stop Kristeller: a matter of gravity. [updated 2014; cited 15 April 2020]. Available from: https://www.elpartoesnuestro.es/blog/2014/07/01/el-parto-es-nuestro-birth-ours-presents-final-report-campaign-stop-kristeller-matter-gravity.
- 26. Hutton EK, Hassan ES. Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials. JAMA 2007;297(11):1241-52.
- 27. McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term yenidoğans on maternal and neonatal outcomes. Cochrane Database Syst Rev 2013;7:CD004074.
- 28. Bhatt S, Alison BJ, Wallace EM, Crossley KJ, Gill AW, Kluckow M, te Pas AB, Morley CJ, Polglase GR, Hooper SB. Delaying cord clamping until ventilation onset improves cardiovascular function at birth in preterm lambs. J Physiol 2013;591:2113–26.
- 29. World Health Organization. Delayed clamping of the umbilical cord to reduce infant anaemia. [updated 2013; cited 10 April 2018]. Available from: http://apps.who.int/iris/bitstream/10665/120074/1/WHO_RHR_14.19_eng.pdf. 30. American Pediatrt Academy. Neonatal Resuscıtatıon Program. 7TH EDITION [updated 2015; cited 2 March 2018]. Available from: http://alsrc.org/wordpress/wp-content/uploads/2017/07/NRP-2015-7th-ED-UPDATE_-04-2017-Claudia-Reed.pdf
- 31. Royal College of Obstetricians and Gynaecologists. [updated 2015; cited 2 March 2018]. Available from: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/sip14/
- 32. American College of Nurse Midwives. Delayed umbilical cord clamping. Position Stawtement. Silver Spring (MD): ACNM. [updated 2014; cited 2 March 2018]. Available from: http://www.midwife.org/ACNM/files/ACNMLibraryData/UPLOADFILENAME/000000000290/Delayed-Umbilical-Cord-Clamping-May-2014.pdf
- 33. The American College Of Obstetricians and Gynecologists Committee Opinion. Timing of umbilical cord clamping after birth. The American College Of Obstetricians and Gynecologists Women’s Health Care Phsycians 2014;453(1):1-5.
- .34. Türk Neonatoloji Derneği Doğum Salonu Yönetimi Rehberi. [updated 2016; 2 March 2018]. Available from: http://www.neonatology.org.tr/wcontent/uploads/2016/12/dogum_odasi_yonetimi.pdf.
- 35. Yerlikaya A, İldan Çalım S. Erken Ten Tene Temasın Anne ve Yenidoğan Sağlığına Etkisi: Sistematik Derleme. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 2021;24(1):117-30. DOI: 10.17049/ataunihem.631562.
- 36. Ahi S, Borlu A, Balcı E, Günay O. Bebek dostu bir hastanede doğum yapan annelerin doğumdan sonra ilk bir saatte emzirmeye başlama durumları ve ilişkili faktörler. Ahi Evran Medical Journal 2019;3(2):41-7.
- 37. Oygür N, Önal EE, Zenciroğlu A. Turkish Neonatal Society national guideline for the delivery room management. Turk Pediatri Ars 2018; 53(Suppl 1):3-17.
- 38. Foster JP, Dawson JA, Davis PG, Dahlen HG. Routine oro/nasopharyngeal suction versus no suction at birth.Cochrane Database of Systematic Reviews, 2017. doi: 10.1002/14651858.CD010332.pud2.
- 39. Yıkmaz G, Özbek N, Gürakan B. Yenidoğanın Hemorajik Hastalığı. Sürekli Tıp Eğitim Dergisi 2000; https://www.ttb.org.tr/STED/sted0100/st01004.html.
- 40. Darra S. “Normal”, “Natural”, “Good” or “Good Enough” Birth: Examining The Concepts. Nursing Inquiry 2009;16(4):297-305.
- 41. Downe, Susan, ed. Normal childbirth: Evidence and debate. Elsevier Health Sciences, 2008.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 18 Aralık 2023 |
| Gönderilme Tarihi | 5 Temmuz 2022 |
| Yayımlandığı Sayı | Yıl 2023Cilt: 62 Sayı: 4 |
