产科医务工作者对产后避孕的认知及参与现状分析

Analysis of current status of obstetric medical workers' cognition andparticipation in postpartum contraception

目的探讨产科医务工作者对产后避孕的认知及咨询服务开展情况。方法2021年3月18日至4月22日在山东省内20家医院开展的一项针对产科医生及助产士的关于对避孕方法认知及参与产后避孕服务现状的横断面调查。结果共有209份产科医生及134份助产士的调查问卷纳入分析。产科医生对经阴道及剖宫产分娩产妇主动产后避孕宣教率为50.72%、63.16%。28.71%产科医生及25.37%助产士建议产妇向专业计划生育工作者咨询。男用避孕套被认为是产后6个月内最适宜的避孕方法,而且产后6个月后,男用避孕套仍是主要避孕方法。49.56%产科医务工作者认为男用避孕套是最好的避孕方式,且48.69%认为是最舒适的,53.64%表示现在(或将来)应用男用避孕套进行避孕,而宫内节育器分别为41.98%、33.82%及33.82%。75.12%的产科医生及70.90%的助产士反对产时或者产后即刻放置宫内节育器。产科医生及助产士避孕方式的认知及实际应用一致性分别为56.5%、32.1%,两组比较差异有统计学意义(χ^(2)=19.469,P<0.001)。结论产科医生及助产士均缺乏产后避孕服务的知识及意识,男用避孕套成为产后避孕首要推荐,长效可逆避孕方式推荐率低,应加强产科医务工作者避孕咨询培训。

Objective To explore the awareness of obstetric medical workers on postpartum contraception and the participation in consultation services.Methods A cross-sectional survey including the cognition on contraceptive methods and the participation in postpartum contraceptive services was conducted in 20 hospitals in Shandong Province from Mar.18 to Apr.22,2021.Results 209 questionnaires from obstetrician and 134 questionnaires from midwives were assessed and formed the basis for analysis.There were only 50.52% obstetricians actively provided contraceptive counselling for the women vaginal delivery and 63.16% for cesarean delivery.28.71% obstetricians and 25.37% midwives preferred to suggest consulting with professional family planning provider during contraceptive counselling.Both obstetricians and midwives agreed that male condoms were the most appropriate contraceptive method for women in the first 6 months after delivery, and after 6 months postpartum, the male condom was still the main method of contraception.49.56% of obstetric medical workers believed that the male condom was the best contraceptive method, and 48.69% believed it was the most comfortable, 53.64% believed that the male condom was used for contraception now(or in the future),and the proportions about IUDs were 41.98%,33.82% and 33.82%,respectively.75.12% of obstetricians and 70.90% of midwives opposed the placement of intrauterine devices during or immediately after delivery.Obstetricians and midwives had 56.5% and 32.1% consistency in their awareness and practical application of contraceptive methods, respectively, and there was no significant difference between the two groups(χ~2=19.469,P<0.001).Conclusion The knowledge and awareness of postpartum contraceptive services in obstetricians and midwives were limited.Male condoms had become the primary recommended and long-acting reversible contraception was rarely recommended as postpartum contraceptive methods.It is necessary to strengthen the contraceptive consultation training for obstetric medical workers.