台灣護理－－助產業務的變革

Changes in Nurse-Midwifery Practices in Taiwan

護理──助產人員在孕、產婦及嬰兒的照護系統扮演著重要角色，在台灣，助產士在婦幼保健上的貢獻，為不容忽視的歷史。護理－－助產人員在1960年代之前一直是在婦嬰照護上是主要的照護者，後來由於諸多因素而沈寂。在養成教育上以往主要是在職校與專科層級，後來中斷培訓，於1999年才恢復而提升至大學及研究所。護理－－助產人員認為懷孕、生產與哺乳是一連串自然的過程，長久以來的傳統就是讓婦女掌握懷孕及生產，所提供的健康照護包括：合宜的醫療諮詢、與醫師的合作管理個案及轉介，參與婦女的健康促進和疾病預防等。在台灣若要使護理－－助產專業能發揮無比之潛能，得落實教、考、用三個環節，方能提昇護理－－助產人員形象及建立其專業地位，這是護理－－助產政策未來應努力的方向。

Nurse-midwifery professionals play an important role for pregnant women in the healthcare system, providing assistance to both expectant women and their newborn children. In Taiwan, midwifery professionals have contributed significantly to women and infant health. Before 1960s, nurse-midwives were the main nursing caregivers for women and babies. However, this changed for a variety of reasons. In the past, the education of much of the population was limited to vocational high schools and five-year junior colleges. In 1999, midwifery education was extended to the college and graduate school levels. Nurse-midwives hold that pregnancy, childbirth, and breastfeeding represent natural processes. Traditionally speaking, women have been in control of pregnancy and childbirth. Healthcare offered includes the following items: proper medical consultation, collaboration with obstetricians on case management, referral of cases to other institutions, participation in women's health promotion and illness prevention. In Taiwan, in an attempt to realize the great potential of the nursemidwifery profession, we hope to emphasize the three stages of teaching, examination, and employment. In the future, we hope that nurse-midwifery policies will be directed to promote the image of nurse-midwives and confirm their status as healthcare professionals.