title: A proposed mother-friendly childbirth model for Taiwanese women and obstetricians' attitudes toward it.
abstract: OBJECTIVE
  Pleasant and humane childbirth is every mother's wish. The objective of this study was to propose a practicable mother-friendly childbirth model tailored to Taiwanese women in order to improve the quality of perinatal care and maternal satisfaction.
  
  
  METHODS
  In this study, the guidelines of several countries were systematically reviewed, and a standard set of clinical guidelines were established by a focus group. In addition, a total of 172 Taiwanese obstetricians were visited, and a cross-sectional study of these obstetricians' attitudes toward the practicality and effectiveness of the model was performed using questionnaires.
  
  
  RESULTS
  A total of 10 suggestions were developed for this woman-friendly childbirth model, including: (1) intermittent fetal monitoring for low-risk pregnancy, (2) no routine enema, (3) no routine perineal shaving, (4) no routine restricted oral intake, (5) no routine parenteral fluid support, (6) no routine elective amniotomy, (7) nonpharmacological pain management, (8) upright position during childbirth, (9) delayed pushing, and (10) restrictive episiotomy. Taiwanese obstetricians approved of no routine oral intake restriction and providing nonmedical pain relief. The majority of obstetricians disagreed that perineal shaving and routine elective amniotomy were necessary, and agreed to modify their practice according to the suggestions. Suggestions were still being debated, such as no routine parenteral fluid support, using an upright position for childbirth, and delayed pushing. Intermittent fetal monitoring for low-risk pregnancy, no routine enema, and restrictive episiotomy were questioned by many Taiwanese obstetricians.
  
  
  CONCLUSIONS
  Several suggestions were made in this model. However, there was still no consensus of Taiwanese obstetricians. More evidence for the advantages and disadvantages of the various suggestions was needed to convince Taiwanese obstetrician to modify their routine practice.
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Shin-Yu
authors.initials: SY
authors.lastname: Lin
authors.affiliation: National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Yeh
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Heng-Cheng
authors.initials: HC
authors.lastname: Hsu
authors.affiliation: Department of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: ylyang@ntu.edu.tw.
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: leecn@ntu.edu.tw.
authors.forename: Chien-Nan
authors.initials: CN
authors.lastname: Lee
authors.affiliation: National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Su-Chen
authors.initials: SC
authors.lastname: Kuo
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods*; D004733:Enema; D004841:Episiotomy; D005260:Female; D005323:Fetal Monitoring; D017144:Focus Groups; D006801:Humans; D009774:Obstetrics; D059408:Pain Management; D056888:Patient Positioning; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D013624:Taiwan
keywords: amniotomy; enema; episiotomy; intermittent fetal monitoring; mother-friendly childbirth