产妇产后对分娩方式的再认识

Women's perceptions of delivery modes after delivery.

目的:探讨产妇产后近期对分娩方式的再认识。方法:采用前瞻性研究设计,在产后健康检查时开展面对面问卷调查和小组访谈。结果:有598例产妇(其中剖宫产、阴道分娩组各299例)回答了再次选择分娩方式时的选择意愿。共有63.7%的对象愿意选择阴道分娩,其中剖宫产组产妇接近一半将重新选择阴道分娩,而78.6%的阴道分娩产妇坚持原来的分娩方式。两组选择阴道分娩的最主要原因都是“阴道分娩产后恢复快”和“阴道分娩对母儿有利”。阴道分娩产妇选择剖宫产的主要原因是惧怕所经历的阴道分娩痛,而剖宫产组选择剖宫产的主要原因是剖宫产痛苦少、安全并且快捷方便,避免阴道分娩痛。小组访谈结果表明多数产妇当初分娩方式的选择受身边年轻母亲分娩方式的影响。两种不同分娩方式的产妇都比较满意自己所经历的分娩方式,只是阴道分娩组产妇对于都要进行会阴侧切感到不满意。结论:多数产妇满意自己所经历的分娩方式,再次选择时多数倾向选择阴道分娩。改进围产期服务模式和实施产科适宜技术,将更能体现两种分娩方式中阴道分娩的比较优势。

Objective： To explore the perceptions of new mothers regarding delivery modes. Methods： Women without complicated pregnancy were interviewed face - to - face with questionnaires and through focus group discussion ＇after delivery in a prospective study. Results： 598 women completed an early postpartum questioncaire, 299 each in caesarean section and vaginal delivery groups. 63, 7% of all primiparas would opt for yaginal delivery if given the chance to choose the delivery mode again. Half in the caesarean section group and 78. 6% of vaginal delivery group made such choice. Women who would like to choose vaginal delivery in both groups were mostly for faster recovery and for that vaginal delivery was beneficial to both mother and infant health. 71. 4% in the vaginal delivery group who preferred caesarean section attributed their choice to avoid the experienc, ed labor pain. Most of those who stick to their previous mode in the caesarean section group regarded caesarean section as a less pain, safer, and more convenient mode. The findings in the focus group discussions were similar to those of the questionnaires. The previous choice of delivery mode was affected hy other new mothers＇ maternity experiences. All of them were almost satisfied with their respective mode of delivery. While many primiparas in the vaginal delivery group were dissatisfied with the routinely performed episiotomy. Conclusion： Almost all primiparas in both groups are satisfied with their respective mode of delivery. Most of them would prefer vaginal birth if they have the chance to choose the delivery- mode again. To improve the quality of maternal health care and evidence - based obstetric practices that may be widely used with vaginal birth will show the spontaneous delivery＇s superiority over the surgical interventions.