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Facilitators and barriers in the humanization of childbirth practice in Japan.doc

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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