北京市剖宫产育龄妇女产后避孕意愿分析

Contraceptive willingness of women after cesarean section in Beijing

为了了解北京市剖宫产术后妇女的避孕意愿及其影响因素,在北京市城、近、郊区采用分层整群抽样方法随机抽取2011年7月—2011年12月期间接受剖宫产手术的产妇364名,进行问卷调查。采用卡方检验和多因素Logistic回归方法对问卷调查结果进行分析。结果显示,被调查妇女平均年龄为(31±4.53)岁,剖宫产术后计划恢复性生活时间中位数为7周。96.43%的妇女对于产后可以采用的避孕方法并不清楚。仅有27.74%的妇女表示产后会尽早或立即采取避孕措施,避孕套是妇女首选的产后避孕方法,占75.27%。72.25%的妇女没有避孕计划或要等到产后3个月才开始避孕。62.64%的妇女在剖宫产术后接受了避孕指导,医生推荐的产后避孕方法中避孕套占首位。医生强调剖宫产术后避孕的重要性、妇女具备正确产后避孕知识是妇女剖宫产术后尽早开始避孕的保护因素。剖宫产妇女对产后避孕服务有较高需求,希望在产前保健或产后访视时能得到专业人员的产后避孕咨询指导。剖宫产术后再次妊娠存在健康风险,剖宫产妇女产后尽早落实避孕措施应引起高度关注。建议尽快针对剖宫产妇女开展产后避孕服务,摸索适合北京的服务模式,以满足需求,减少产后非意愿妊娠的发生,降低剖宫产术后人工流产的风险。

To learn the contraceptive willingness and it＇s affecting factors among women after cesarean section in Beijing. Stratified cluster sampling and randomized data collection by questionnaires of women after cesarean section from July 2011 to December 2011 in various areas in Beijing and data analyzed by Chi-squared test and Logistic Regression. The results show that the average age of the target women was（31±4.53） years old. The median of the women＇s planning intercourse after cesarean section was 7 weeks. 96.43 % of the women were unaware of the methods for postnatal contraception. Only 27.74 % of them will take contraception as soon as possible after cesarean section and 75.27 % of them preferred condom. 72.25 % of the women had no plan for contraception or will take contraceptive methods until 3 months after cesarean section. 62.64 % of the women received postnatal contraceptive counseling,condom ranked the first among the methods recommended by the doctors. The protecting factors for women take contraception as soon as possible after cesarean section were that the doctors emphasize the importance of postnatal contraception and women aware of postnatal contraception. Unmet needs of postnatal contraception were high among the target women. They hoped to get professional counseling during antenatal care or postnatal home visits. There are risks of pregnancy after cesarean section. More attention should be paid for contraception implementation as soon as possible after cesarean section. It is suggested that postnatal contraceptive services should be carried out to explore the service model in Beijing and to meet the unmet needs to reduce unwanted pregnancy after cesarean section which will be helpful to decrease the risk of induced abortion after cesarean section.