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Facilitators and barriers in the humanization of childbirth practice in Japan
Behruzi et al. BMC Pregnancy and Childbirth 2010, 10:25
/1471-2393/10/25
RESEARCH ARTICLE
Open Access
Facilitators and barriers in the humanization of Research article
childbirth practice in Japan
Roxana Behruzi*1, Marie Hatem 2, William Fraser 3, Lise Goulet 4, Masako Ii5 and Chizuru Misago6
Abstract
Background: Humanizing birth means considering womens values, beliefs, and feelings and respecting their dignity
and autonomy during the birthing process. Reducing over-medicalized childbirths, empowering women and the use
of evidence-based maternity practice are strategies that promote humanized birth. Nevertheless, the territory of birth
and its socio-cultural values and beliefs concerning child bearing can deeply affect birthing practices. The present
study aims to explore the Japanese child birthing experience in different birth settings where the humanization of
childbirth has been indentified among the priority goals of the institutions concerned, and also to explore the
obstacles and facilitators encountered in the practice of humanized birth in those centres.
Methods: A qualitative field research design was used in this study. Forty four individuals and nine institutions were
recruited. Data was collected through observation, field notes, focus groups, informal and semi-structured interviews. A
qualitative content analysis was performed.
Results: All the settings had implemented strategies aimed at reducing caesarean sections, and keeping childbirth as
natural as possible. The barriers and facilitators encountered in the practice of humanized birth were categorized into
four main groups: rules and strategies, physical structure, contingency factors, and individual factors. The most
important barriers identified in humanized birth care were the institutional rules and strategies that restricted the
presence of a birth companion. The main facilitators were womens own cultural values and beliefs in a natural birth,
and institutional strategies d
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