Abstract：
BACKGROUND: The impact of midwifery, and especially Indigenous midwifery, care for Indigenous women and communities has not been comprehensively reviewed. To address this knowledge gap, we conducted a mixed-methods systematic review to understand Indigenous maternal and infant outcomes and women\'s\' experiences with midwifery care.
METHODS: We searched nine databases to identify primary studies reporting on midwifery and Indigenous maternal and infant birth outcomes and experiences, published in English since 2000. We synthesized quantitative and qualitative outcome data using a convergent segregated mixed-methods approach and used a mixed-methods appraisal tool (MMAT) to assess the methodological quality of included studies. The Aboriginal and Torres Strait Islander Quality Appraisal Tool (ATSI QAT) was used to appraise the inclusion of Indigenous perspectives in the evidence.
RESULTS: Out of 3044 records, we included 35 individual studies with 55% (19 studies) reporting on maternal and infant health outcomes. Comparative studies (n = 13) showed no significant differences in mortality rates but identified reduced preterm births, earlier prenatal care, and an increased number of prenatal visits for Indigenous women receiving midwifery care. Quality of care studies indicated a preference for midwifery care among Indigenous women. Sixteen qualitative studies highlighted three key findings - culturally safe care, holistic care, and improved access to care. The majority of studies were of high methodological quality (91% met ≥80% criteria), while only 14% of studies were considered to have appropriately included Indigenous perspectives.
CONCLUSIONS: This review demonstrates the value of midwifery care for Indigenous women, providing evidence to support policy recommendations promoting midwifery care as a physically and culturally safe model for Indigenous women and families.
METHODS: We searched nine databases to identify primary studies reporting on midwifery and Indigenous maternal and infant birth outcomes and experiences, published in English since 2000. We synthesized quantitative and qualitative outcome data using a convergent segregated mixed-methods approach and used a mixed-methods appraisal tool (MMAT) to assess the methodological quality of included studies. The Aboriginal and Torres Strait Islander Quality Appraisal Tool (ATSI QAT) was used to appraise the inclusion of Indigenous perspectives in the evidence.
RESULTS: Out of 3044 records, we included 35 individual studies with 55% (19 studies) reporting on maternal and infant health outcomes. Comparative studies (n = 13) showed no significant differences in mortality rates but identified reduced preterm births, earlier prenatal care, and an increased number of prenatal visits for Indigenous women receiving midwifery care. Quality of care studies indicated a preference for midwifery care among Indigenous women. Sixteen qualitative studies highlighted three key findings - culturally safe care, holistic care, and improved access to care. The majority of studies were of high methodological quality (91% met ≥80% criteria), while only 14% of studies were considered to have appropriately included Indigenous perspectives.
CONCLUSIONS: This review demonstrates the value of midwifery care for Indigenous women, providing evidence to support policy recommendations promoting midwifery care as a physically and culturally safe model for Indigenous women and families.
摘要：
背景：助产的影响，尤其是土著助产，没有全面审查对土著妇女和社区的照顾。为了解决这个知识差距，我们进行了一项混合方法系统评价,以了解土著母婴结局和妇女在助产护理方面的经验.
方法：我们搜索了9个数据库，以确定报告助产和土著母婴分娩结局和经验的主要研究，自2000年以来以英文出版。我们使用融合的分离混合方法方法综合了定量和定性结果数据，并使用混合方法评估工具（MMAT）评估了纳入研究的方法学质量。原住民和托雷斯海峡岛民质量评估工具（ATSIQAT）用于评估证据中是否包含土著观点。
结果：在3044条记录中，我们纳入了35项单独研究,其中55%(19项研究)报告了母婴健康结局.比较研究（n=13）显示死亡率没有显着差异，但发现早产减少，早期的产前护理，越来越多的土著妇女接受助产护理。护理质量研究表明，土著妇女更喜欢助产护理。16项定性研究强调了三个关键发现-文化安全护理，整体护理，改善获得护理的机会。大多数研究具有较高的方法学质量（91％符合≥80％的标准），而只有14%的研究被认为适当地纳入了土著观点。
结论：本综述证明了助产护理对土著妇女的价值，提供证据支持政策建议，促进助产护理作为土著妇女和家庭的身体和文化安全模式。
方法：我们搜索了9个数据库，以确定报告助产和土著母婴分娩结局和经验的主要研究，自2000年以来以英文出版。我们使用融合的分离混合方法方法综合了定量和定性结果数据，并使用混合方法评估工具（MMAT）评估了纳入研究的方法学质量。原住民和托雷斯海峡岛民质量评估工具（ATSIQAT）用于评估证据中是否包含土著观点。
结果：在3044条记录中，我们纳入了35项单独研究,其中55%(19项研究)报告了母婴健康结局.比较研究（n=13）显示死亡率没有显着差异，但发现早产减少，早期的产前护理，越来越多的土著妇女接受助产护理。护理质量研究表明，土著妇女更喜欢助产护理。16项定性研究强调了三个关键发现-文化安全护理，整体护理，改善获得护理的机会。大多数研究具有较高的方法学质量（91％符合≥80％的标准），而只有14%的研究被认为适当地纳入了土著观点。
结论：本综述证明了助产护理对土著妇女的价值，提供证据支持政策建议，促进助产护理作为土著妇女和家庭的身体和文化安全模式。
