上午9点，北京大学第一医院产科病房，刘军像每天一样开始查房，一个刚分娩不久的产妇和新生的婴儿幸福地偎依在一起，刘军细心地指导她怎样第一次给婴儿喂奶，另一名将上产床的产妇对无痛分娩有顾虑，担心对孩子不利，刘军耐心地给她解释：“无痛分娩采用的麻醉剂量不到剖宫产的1/10，不会对孩子造成影响。”整个产房秩序井然，穿着绿色消毒服的医务人员忙碌地穿梭在产妇中间，测胎心，量血压，询问感觉，轻言安慰……很多产妇并不知道，她们不是医生，也不是普通的护士，她们真正的职业是——助产士。

Morning at 9 o 'clock，Peking University first hospital maternity ward，Liujun like everyday began to ward inspection，A just delivery the near maternal and newborn babies happily snuggle together，Liujun careful guidance how she first breast-feeding，Another on the obstetric table's maternal to eape scruples，To worry about childern，Liujun patiently explain to her：“Eape using anesthesia dose less than 1/10 of the cesarean section，Will not affect to the child。”The delivery room in order，Wearing green disinfection suit medical staff busily shuttling back and forth in the maternal intermediate，Measuring cardiac，Blood pressure，Ask feel，Comforted...Many pregnant women do not know，They are not doctors，Also is no ordinary nurses，Their real job is - midwife。

　　刘军是持证上岗的资深助产士，同时也是产房护士长，她在这里已经工作了22年，她和她的同事们接生的孩子超过万名，“干得时间越久，我越热爱这个工作，因为我用自己的手把新生命迎接到人世间。”然而现在愿意做助产士的人并不多，“专业性强，风险大，常年超负荷工作，人手一直不够。”刘军有些无奈。

Liujun is senior midwife of card mount guard，At the same time also is delivery room head nurse，She have been working here for 22 years，She and her colleagues birth child more than，“Do the longer time，The more I love this job，Because I use their hands to put new life to meet to the human life。”But now willing to do midwife person is not much，“Professional and strong，Risk big，Perennial work overload，Hands had been enough。”Liujun some helpless。

　　目前，中国将近一半的剖宫产率高居世界第一，它给下一代带来的问题已经引起各界重视，“降低剖宫产率，就必须要保证自然分娩的安全，这就需要大量技术娴熟的助产士，可是现在国内助产士没有专业教育，没有职称体系，看不到职业前景，怎么可能发展呢？”北京大学第一医院妇产科主任、中华医学会围产医学分会候任主任委员杨慧霞教授对记者说。

At present，China nearly half of the rate of cesarean section at the world first，It to the next generation of the problem of the attention from all walks of life has been a cause，“Reduce the rate of cesarean section，You must guarantee the safety of natural childbirth，This needs a large number of skilled midwife，But now the domestic midwife no professional education，No title system，Can't see career prospects，How could it be possible development？”The first hospital, Beijing university, director of the department of gynaecology and obstetrics、The Chinese medical association WeiChan medical branch director professor of president-elect YangHuiXia told reporters。

　　由护士转岗 学接生全靠“师傅”带

The nurse job-transfer learn all by birth“teacher”belt

　　“我的接生技术全是当年带我的一位老护士教的，每个助产士都有一个这样的‘师傅’，老人带新人，师傅带徒弟，真正的手把手传帮带。”刘军告诉记者，她们的教室就是产房，老师就是年长的同事，“一般人很难想象，专业性这么强的工作是靠这种方式传授的。”目前在北京的各大医院，培养助产士基本都是采取这种方法，因为无论是中专还是大学，都没有助产这个专业。

“My birth technology is full of the band one of my old nurse teaching，Each midwife has such a‘teacher’，The old man with new，Teacher train an apprentice，The real hand-on ChuanBangDai。”Liujun told reporters，Their classroom is the delivery room，The teacher is older colleagues，“The average person it is hard to imagine，Professional so strong work is to rely on this way of teaching。”At present in Beijing's each big hospital，Cultivate midwife basic it is to adopt this method，Because whether technical secondary school or university，Have the professional midwifery。

　　记者了解到，在多数西方国家，需要在接受大学四年护士专业教育的基础上，再经过18个月的专门培训和资质考试之后，才能成为助产士，而在我国，情形大相径庭。

The reporter understands，In most western countries，Need in the college four years professional education on the basis of the nurse，Then after 18 months of special training and qualifications after the exam，To become a midwife，While in our country，Situations vary widely。

　　北京大学第一医院产房目前一共有15名助产士，最大41岁，最小二十出头，“全都是从护士里挑出来的，挑护士里特别优秀的，动作麻利，反应快，有责任心，能吃苦，这才具有被培养成助产士的潜质。”刘军表示，团队人员都是这样“脱颖而出”，被挑选出来进行助产士培养，“先进产房实习3个月，跟着老护士学习接生，最困难的是侧切、缝合这些专业技术很强的工作，已经完全超出护士的工作范围，但助产士必须熟练掌握，我们只能台下利用模具反复练习，切了缝，缝了切。”而理论知识，全靠自学，“一本《妇产科学》下班后自己看，不懂的记下来，找院里的高年资医生去问。”科室一年内也会安排多次高年资医生甚至教授授课，刘军非常珍惜这样的机会。

The first hospital, Beijing university, delivery room at present a total of 15 midwife，Maximum 41 years old，Minimum in their early 20 s，“From all the nurses pick it out，Pick the nurse special excellent，Action supple，Quick response，Has the sense of responsibility，Can bear hardships，This is the was trained midwife potential。”Liujun said，Team personnel are like that“Stand out”，Was picked for midwife culture，“Advanced delivery room practice 3 months，Follow the old nurse study deliver，The most difficult is side cut、Suture these professional technical very strong job，The nurse has completely beyond the scope of work，But the midwife must grasp skilled，We can only use the mold to practice repeatedly，Cut the seam，Seam the cutting。”And the theoretical knowledge，All by self-study，“a《Obstetrics and gynecology》See for yourself after work，Don't understand down，In looking for the high qualification to ask the doctor。”Department would like to arrange a year many high qualification doctors even professors lecture，Liujun very cherish this opportunity。

　　在产房接生100个婴儿之后，就有了参加助产士考核的“底气”，“医院会出具接生100个婴儿的证明，然后到市里参加3天脱产的助产技能培训课，最后参加考试，笔试加操作，合格之后，就能拿到助产士的证书，具有独立从事助产专业，签病历和接生的资格。”

In the delivery room after birth 100 babies，Have to participate in the assessment of midwife“Bottom spirit”，“The hospital will deliver 100 issued by a baby proof，And then to the city to participate in 3 days of full-time midwifery skills training course，Finally take the exam，Written examination and operation，Qualified after，Can get the certificate of midwife，Independent engaged in professional midwifery，Sign the medical records and deliver qualifications。”

　　这种培训方式决定了几乎所有的助产士都是由护士转岗而来的，“总是觉得自己理论知识不够，因为学得不系统、不全面。”刘军有些遗憾。目前在这个行业里，最被看重的还是经验，“年过四十的资深助产士在产房里就是个‘宝’，新分来的小医生，甚至研究生都要做她的徒弟，有这样经验丰富的助产士在产房，大家心里就不慌。”

This training method determines the almost all the midwife are made by the nurse and change，“Always feel theoretical knowledge is not enough，Because learn not system、Not comprehensive。”Liujun some regret。At present in this industry，The most esteemed or experience，“Forty years of senior midwife in the delivery room is the a‘treasure’，New points of little doctor，Even graduate student have to do her disciple，Have such experienced midwife in the delivery room，Everybody's heart will not panic。”

　　上一宿夜班 给产妇鼓劲嗓子喊哑了

A night night shift to maternal pull for his voice dumb

　　“今年大家都抢着生龙宝宝，产房经常满员，有时候还要加床，我们科15个助产士，每天三班倒，忙得脚不沾地了，大家都说我们像一阵风儿。”刘军笑着告诉记者，轻松的语气却难以掩盖她们超负荷工作的事实，“比护士累得多。”

“This year everyone rob to born baby dragon，Delivery room often full strength，Sometimes also extra bed，Our families 15 a midwife，Every three shifts，Busy feet do not touch the ground，Everyone said that we like a gust of wind。”The LiuJunXiao told reporters，Relaxed mood but difficult to hide the fact that they work overload，“Much more tired than the nurse。”

　　每半小时给产妇测一次胎心，每2小时观察一次产妇宫缩，每4小时检查一次产妇宫口打开情况，随时解答产妇的问题，指导她们用各种物理方法减轻阵痛，出现异常情况及时通知医生……“在待产室上一天班，基本上腿就走肿了。”到了关键的接生时刻，那是真正的“体力活”，“前几天有个夜班，赶上扎堆生孩子，一晚上接生了十余个，我们嗓子都喊哑了！”

Every half an hour to maternal measuring a cardiac，Every 2 hours to observe a maternity contractions，Every 4 hours check a puerpera palace mouth open situation，Answer the problem of women at any time，Guide them with all kinds of physical method alleviate pains，Abnormality of timely notify the doctor...“In the labor room one day，Basically legs walk swollen。”The key to deliver time，That is the true“Physical strength live”，“A few days ago a night shift，Catch up with the baby gathers together，A night to deliver the more than ten，We all shouted throat dumb！”

　　为什么助产士嗓子会哑？没见过产房里那种震撼情景的人不会明白，光听声音，会以为她们在观看体育比赛，“加油，再用点力，你肯定没问题，条件这么棒！”“最后一次，这回一定行，我们给你喊，一、二、三，使出所有力气……”抓着产妇的手，按摩产妇的肚子，她们充满激情地给产妇加油鼓劲，伴随着她们的呼喊，一声婴儿的啼哭破空而出，这是最幸福的时刻，也是她们汗透重衣的时刻。

Why midwife voice will be dumb？Haven't seen in the delivery room that shocked the scene people don't understand，Light to listen to the voice，Will think they are watching sport，“refueling，Garnish with point force，Are you sure no problem，Conditions so great！”“The last time，This time will，We give you shout，a、two、three，Use all the strength...”Holding the hand of women，Massage maternity in the stomach，They are full of passion to maternal come on pull for，With their cry，A sound of the cry of baby ride out，This is the most happy time，And they HanTou heavy clothes moment。

　　婴儿降生之后，她们还有更多的事情要做，婴儿复苏、打分、称重、按手印、剪脐带、清理胎盘、指导产妇哺乳……“夜班是从下午5点到早上9点，整整16个小时，没有一刻能停下来。”这种超强度的工作，对于年过40岁的人来说，其实已经力不从心，“有点干不动了，但是大家还是相互支持坚守着这个岗位，因为人手紧张，更重要的是我们喜欢这个工作。”刘军神色有些黯然：“前一阵，我们有个二十多岁的女孩得了肾炎，累的，还有个三十多岁的，这么年轻竟然得了高血压。”留下的人也都受着职业病的困扰，最普遍的是腰椎间盘突出和失眠。

The baby was born after，They have more things to do，Baby recovery、marking、weighing、According to the fingerprint、Shear umbilical cord、Cleaning placenta、Guidance maternity nursing...“Night shift from 5 p.m. to 9 o 'clock in the morning，A total of 16 hours，No moment can stop。”This super strength work，For over 40 years old people，In fact have ability not equal to one's ambition，“A little dry do not move，But everyone still support each other to the post，Because people nervous，The more important thing is we like this job。”Liujun look some dim：“Before a，We have a more than 20 year old girl got nephritis，tired，There is a more than 30 years old，So young should have high blood pressure。”Leave people also were inspired by the occupational disease problems，The most common is lumbar intervertebral disc and insomnia。

　　招人不容易 坚守靠的是职业良心

Recruit people don't easy to hold by professional conscience

　　“助产士明显配备不足，国家目前没有出台助产士配置的标准，现在是按照护士的标准，是1比0.4，也就是一个助产士负责2至3个产妇，而实际上，我们的工作强度比普通护士要大很多，很多时候忙不过来。”刘军说。培养招收年轻助产士却并不是一件很容易的事，“有些人不愿意来，因为缺乏吸引力，辛苦，有风险，压力大，待遇不高。”

“Midwife obvious equipped with insufficient，Countries are not yet available midwife configuration standards，Now is according to the nurse's standard，Is 1 ratio of 0.4，That is, a midwife responsible for 2 to 3 maternity，But in fact，Our work strength than normal nurse to big many，A lot of times, so he can't come。”Liujun said。Training for young midwife was not a very easy thing，“Some people don't like to come，Because of the lack of attractive，hard，Have risk，Pressure big，Salary is not high。”

　　对助产士来说，比工作累更严峻的考验是承受风险和压力。“在我们医院，剖宫产率低于全国水平，除非产妇有严重并发症、盆骨异常、孩子过大等这些医学指征，必须要剖宫产的，除此以外我们都建议产妇自然分娩，不给剖，这就要求我们最大限度保证自然分娩的安全。”

For to midwife，Hard work than more severe test is withstanding risks and pressure。“In our hospital，Cesarean section rate was lower than the national average，Unless there is a serious maternal complications、Pelvis anomaly、Children too these medical indications，Must the cesarean section，In addition we are suggested to maternal natural childbirth，Don't give cutting，This requests us maximum guarantee natural childbirth security。”

　　我国妇幼专家庞汝彦教授曾一针见血地指出助产士面临的风险：“这么多的家庭就等着这一个孩子。如果没给剖宫产，真出现一点问题，那医护人员就要承担责任。”其实，孕妇和家属并不了解剖宫产本身对胎儿和孕妇也有很多影响，并非绝对安全……

Women and children in China PangRuYan expert professor has been quick to note midwife risks：“So many families are waiting for this one child。If you don't give cesarean section，There is a problem，The medical staff will bear the responsibility。”In fact，Pregnant women and families don't know cesarean section itself to the fetus and pregnant women also have a lot of influence，It is not absolute safety...

　　“没有别的办法，我们只能尽力把自己的工作做到更好，对产程监护更细致。”刘军表示，有一次，她发现有个产妇还没到分娩的时间，却不由自主地在用力，似乎不大对劲，她检查了一下，发现是胎位不正，这种情况有可能造成难产，她把这名产妇扶起来，让她下地活动，这样有可能将胎位纠正过来，这样的情况很常见，全靠助产士细心观察。“有时候折腾一夜还生不下来，产妇疲惫不堪，自己都想放弃了，我们就要不断鼓励她，劝她吃东西，增加体力，坚持自己分娩。”

“There is no other way to，We can only do our best to do their job do better，For more detailed process monitoring。”Liujun said，once，She found a maternity haven't to the time of delivery，But in spite of oneself in the force，Jangled seems to，She examined，Discovery is malposition，This kind of situation is likely to cause dystocia，She put a maternity up.where，Let her down activities，This is probably going to be fetal lie to correct it，This situation is very common，All by midwife careful observation。“Sometimes flounder at night do not come down，Maternity tired，Oneself all want to quit，We will continue to encourage her，Advised her to eat，Increase physical，Insist on your delivery。”

　　助产士手中是“一人两命”，没有过硬的技术和强大的心理难以应对，这也是她们中的很多人失眠和患高血压的原因，然而这件事在刘军口中换了一个说法：“一个人住院，两个人出院，这也是我们这个艰辛工作的快乐和幸福所在。”她对记者讲了一件小事：“有一次我在西单逛商场，忽然有个陌生女人特别激动地跑过来拉我，原来十多年前我曾经给她接生，她说一辈子都能认得出我，我特别感动。”

Midwife hand is“A person with two life”，No good technology and strong psychological difficult to deal with，It is also many of their people with insomnia and suffer from the causes of high blood pressure，However this thing in liujun mouth in a statement：“A man in，Two personal discharge，This is also our hard work in the joy and happiness。”She told the reporters speak a little thing：“Once I in xidan shopping，Suddenly there was a strange women especially excited to run to come over to pull me，For ten years ago I had to her baby，She said a lifetime can recognize me，I am very touched。”

　　也许正是因为这份感动，能让刘军这样的资深助产士在这个岗位上坚守二十多年，“靠的是爱和良心。”她说，“分娩是一个女人最艰难、最无助的时刻，她们能依靠和信任的只有我们。”

Perhaps it is because the move，Can let liujun such senior midwife in this post stick to more than 20 years，“By love and conscience。”She said，“Childbirth is a woman the most difficult、The most helpless moment，They can rely on and trust only we。”

　　啥时能评职称 助产士想找自己的“组织”

What can professional evaluation midwife want to find their own“organization”

　　纵使从事着一份堪称“造福众生”的职业，刘军的职业描述和晋升履历也只能填上简单的“护士”两个字，“我们只能走护士的职称晋升体系，我虽然做了22年，可现在连助产士这个正式职业名称都没有，更不用说职称评定了。”很多产妇和家属不了解她们的工作，甚至医院的同事也不清楚她们究竟做的是什么，她们似乎处于职业的空白地带。

Even if engaged in a can“To benefit all beings”career，Liujun job description and promotion resume also can fill in the simple“The nurse”Two words，“We can only go the nurse's title promotion system，Although I do 22 years，But now even the midwife this formal professional name all have no，Not to mention the title assess。”Many mothers and families don't know their work，Even hospital colleagues don't know they actually do is what，They seemed to be in the professional gap。

　　助产在中国的医学教育体系中基本也是一片空白，记者了解到，以北京大学的护理系为例，大专生在产科见习时间为一周，生产实习三周；本科生在产科见习时间仅为一天，生产实习三周。随着医院剖宫产率的提高，不少学生在见习、实习期间自然分娩见过的较少。

In China's medical education midwifery system basic is a blank，The reporter understands，By Beijing university nursing departments as an example，Junior college student in obstetric practice time for a week，Production practice three weeks；Undergraduates in obstetric practice time only for a day，Production practice three weeks。With the improvement of hospital cesarean section rate，Quite a few students in practice、During my internship natural childbirth seen less。

　　助产士的缺乏和不受重视直接导致了剖宫产率的居高不下，因为没有人为自然分娩“保驾护航”，谁还愿意冒这个险？

The lack of midwife and ignored directly led to the cesarean section rate was high，Because there is no artificial natural childbirth“escort”，Who would like to take the risk？

　　刘军说她的愿望很简单，成为一名真正意义上的职业助产士，有相关理论和专业教育，有独立的职称晋升体系，有自己的“组织”。“我们科的助产士里有一名本科生和一名研究生，她们现在看重的是这个职业的技能，但如果没有发展前景和上升空间，很难留住人才。”

Liujun said she desire is very simple，To become a real professional midwife，Have related theory and professional education，Independent professional title evaluation system，Have their own“organization”。“Our section midwife has an undergraduate and a graduate student，They now value is the professional skills，But if there is no development prospects and rise space，It is difficult to keep talents。”

　　产科主任杨慧霞教授告诉记者，医学界人士正在着手组建助产士的组织，“去年，在全国围产医学年会上，中华医学会围产学分会积极组建了‘围产护理专业组’，其中包括助产专业和新生儿护理专业，希望不久的将来，能建立助产专业委员会。”她告诉记者，从上世纪90年代，助产学校以及医学院校的助产专业开始萎缩，现在基本上已经没有了，“减少剖宫产率，就要保证自然分娩的安全，就需要专业技能很强的助产士队伍，现在我国学术团体开始关注这件事，更重要的是要得到政府的重视，恢复助产专业的学校教育，建立职称评定系列，明确界定助产士的责任。”

Maternity YangHuiXia director professor told reporters，In the medical world, they are a midwife to the organization，“Last year，In the national WeiChan medical annual meeting，The Chinese medical association WeiChan actively learn branch established‘WeiChan professional nursing care’，Including obstetric professional and neonatal care professional，Hope in the near future，Can set up professional committee of birth。”She told reporters，From the 1990 s，Aiding schools and medical colleges and universities of professional midwifery began to atrophy，Now basically has no，“Reduce the rate of cesarean section，To ensure the safety of the natural childbirth，Will need to professional skills strong midwife team，Now China's academic groups begin to pay close attention to this matter，The more important thing is to get the government's attention，Recovery of midwifery professional school education，Establish title assess series，Clearly define the responsibility of the midwife。”

　　“在很多国家，经过注册助产士可以组织开助产中心，对孕妇从怀孕开始进行全程追踪监测，和孕妇成为朋友，除了关注她们的健康，还给她们人文关怀和心理支持，保证孕妇更顺利地自然分娩。助产工作绝不仅仅是在产房里，也不是只有接生那么简单，它应该是一种高端的需求。”说起这些的时候，刘军眼中有很多的憧憬。 (王溦)

“In many countries，After registered midwife can organize open obstetric center，For a pregnant woman from pregnant start on the monitor，And pregnant women to become friends，In addition to pay attention to their health，Back to their humanistic care and psychological support，Ensure that pregnant women more smoothly natural childbirth。Birth is not only work in the delivery room，Not only deliver so simple，It should be a kind of high demand。”Speaking of the time，Liujun eyes have a lot of dreams。 (The king Wei)