剖宫产术后再次妊娠孕妇阴道试产意愿的质性研究

Willingness of Trial of Labor After Cesarean Section in Multiparas:A Qualitative Study

目的探讨剖宫产术后再次妊娠孕妇选择阴道试产的原因,以期了解其影响因素,促进阴道分娩。方法2021年1-6月,目的抽样法选取江苏省3所医院剖宫产术后再次妊娠的足月孕妇23名为研究对象,进行半结构式深度访谈,采用Colaizzi 7步分析法归纳并提炼主题。结果剖宫产术后再次妊娠孕妇阴道试产意愿共提炼出3个主题:选择阴道试产的动机、社会支持对选择阴道试产的作用、对阴道分娩风险及疼痛的恐惧。结论通过多途径引导剖宫产术后再次妊娠孕妇树立正确的生育观,客观认知风险,增加社会支持度,可促进对阴道分娩方式的正确认识,从而改变其再次剖宫产的动机。

Objective To explore the reasons of trial of labor after cesarean section(TOLAC)in multiparas with cicatricial uterus,in order to understand its influencing factors and promote vaginal delivery.Methods 23 full-term mutiparas with cicatricial uterus from 3 hospitals in Jiangsu province were selected by the sampling method,and semi-structured in-depth interviews were conducted.The Colaizzi 7-step analysis method was used to summarize and refine the theme.Results 3 themes of willingness of TOLAC in multiparas were extracted:the motivation of vaginal delivery,the effect of social support on vaginal delivery,and the fear of vaginal delivery risk and pain.Conclusions Multiple ways can be established to guide the multiparas with cesarean section history to establish a correct concept of fertility,objectively recognize the risks,and win social support.It can promote the correct understanding of vaginal delivery mode,thus changing the motivation of cesarean section again.