融合与实践：20世纪初美国护士助产士的出现

通过梳理20世纪初期美国护士助产士出现的历史过程，分析其出现的推动因素。母婴高死亡率问题引发了产科医生与护士对于分娩的不同理解，并且分别在医院与家庭中开展助产实践。护士助产士融合了护理与助产实践，并与医生建立合作关系。在这个过程中，护士助产士良好地平衡了医生与护士之间的观念分歧，并且推动了护理专业范围的拓展。护士助产士的出现带来了对分娩观念的理性思辨，护士助产士的实践模式为未来中国发展助产士、提高母婴健康水平提供了历史借鉴。

Integration and Practice: The Emergence of Nurse-midwife in America in the Early 20th Century

This paper analyzes the motivating factors of the emergence of nurse-midwife in the United States by sorting out the historical process of the emergence of nurse-midwife in the early 20th century. The problem of high maternal and infant mortality gave rise to different understandings of childbirth among obstetricians and nurses, causing different midwifery practices in hospitals and families. Nurse-midwife integrated nursing and midwifery practice and developed collaborative relationships with physicians. In this process, nurse-midwife provided balance between doctors and nurses, and promoted the expansion of the scope of nursing. The emergence of nurse-midwife brought rational speculation on the concept of childbirth, and the success of this practice model provided a historical reference for the development of midwives and the improvement of maternal and child health in China in the future.