二胎政策下初产妇分娩意愿及相关影响因素分析

目的:了解计划生育政策调整下,妊娠晚期初产妇分娩方式意愿以及相关影响因素,为提高孕期妇女分娩知识储备及降低社会性剖宫产率提供依据。方法:采取抽样法,选取我院产检门诊孕周≥36周的875名初产妇作为调查对象,采用半结构式自填问卷调查表,对分娩方式的选择、原因和相关知识掌握情况以及妊娠结局进行调查。结果:选择自然分娩孕妇占总数69.7%。选择自然分娩孕妇各项知识得分,明显高于选择剖宫产孕妇和不确定分娩方式孕妇的各项知识得分,其妊娠结局剖宫产率28.5%,明显低于选择剖宫产孕妇的67.9%和不确定分娩方式孕妇的48.5%,差异具有统计学意义(P<0.05)。选择自然分娩孕妇的主要原因"自然分娩有利于生第二胎"占42.3%;18.5%孕妇选择剖宫产,主要原因"自然分娩疼痛时间太长,坚持不了"占47.5%;11.8%选择不确定,主要原因"不知道两种方式利弊"占51.7%。结论:二胎政策正激励孕妇对自然分娩的选择,正确的分娩认知影响孕妇对分娩方式的选择及妊娠结局。随计划生育政策调整,应针对性加强围产期分娩知识宣教,提高产科质量,积极开展分娩镇痛,加强产时监测,严格剖宫产及会阴侧切指征,降低因社会因素导致的剖宫产率。

Objective:Learn under the family planning policy adjustments, maternity fashion will and related factors early in late pregnancy, pregnant women giving birth in order to improve knowledge reserves and reduce the social rate of cesarean section to provide evidence. Method:Take the sampling method, in our hospital outpatient check-gestational age ≥36 weeks 875 primipara for the survey, semi-structured self-administered questionnaire, the choice of mode of delivery, reasons and relevant knowledge to grasp the situation and investigate pregnancy outcomes. Results:Pregnant women choose natural childbirth 69.7% of the total. Pregnant women choose natural childbirth the knowledge score was significantly higher than the knowledge cesarean select mode of delivery of pregnant women pregnant and unsure of the score, the outcome of pregnancy cesarean section rate of 28.5%, significantly lower than the 67.9% of pregnant women choose cesarean section and 48.5 percent uncertain mode of delivery of pregnant women, the difference was statistically significant(P <0.05). The main reason for pregnant women choose natural childbirth 'natural childbirth in favor of a second child,' accounted for 42.3%; 18.5% of pregnant women choose cesarean section, the main reason for the 'natural childbirth pain for too long, can not stand'(47.5%); 11.8% choose not to OK, mainly because 'I do not know the pros and cons of two ways,' accounted for 51.7%. Conclusion: Two-child policy are encouraging pregnant women choose natural childbirth, the right childbirth cognitive influence the choice of mode of delivery in pregnant women and pregnancy outcome. With family planning policy adjustments, should strengthen targeted delivery of perinatal education knowledge, improve the quality of obstetric and actively carry out analgesia, strengthening intrapartum monitoring, strict indications for cesarean section and episiotomy can reduce cross because of social factors led to cesarean ratio.