Gamble J A, Creedy D K
Faculty of Nursing and Health, Griffith University, Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia.
Birth. 2001 Jun;28(2):101-10. doi: 10.1046/j.1523-536x.2001.00101.x.
Few studies have examined women's preferences for birth. The object of this study was to determine the incidence of women's preferred type of birth, and the reasons and factors associated with their preference.
Three hundred and ten women between 36 and 40 weeks' gestation were recruited from the antenatal clinic of a major metropolitan teaching hospital and the consulting rooms of six private obstetricians in Brisbane, Australia. Participants completed a questionnaire asking about their preferred type of birth, reasons for their preference, preparation for childbirth, level of anxiety and concerns, and the influence of the primary caregiver.
Two hundred and ninety women (93.5%) preferred a spontaneous vaginal birth; 20 women (6.4%) preferred a cesarean section. Of the latter group, most had a current obstetric complication or experienced a previously complicated delivery (p <0.001); 1 woman (0.3%) preferred a cesarean section in the absence of any known current or previous obstetric complication. Women who preferred a cesarean section were more anxious, were generally poorly informed of the risks of this procedure, and/or overestimated the safety of the procedure.
Women who preferred a cesarean section were more likely to have experienced this type of birth previously and to have negative feelings about it. To decrease women's preference for a cesarean section, practitioners should reduce the primary cesarean delivery rate and improve the quality of emotional care for women who require a cesarean section. Caregivers should engage in a sensitive discussion of the risks and benefits of various birth options, including a vaginal birth after cesarean, with women who have previously experienced a cesarean birth before they make decisions about mode of delivery in a subsequent pregnancy.
很少有研究探讨女性对分娩方式的偏好。本研究的目的是确定女性偏好的分娩方式的发生率，以及与其偏好相关的原因和因素。
从澳大利亚布里斯班一家大型都市教学医院的产前诊所和六位私人产科医生的诊室招募了310名妊娠36至40周的女性。参与者完成了一份问卷，询问她们偏好的分娩方式、偏好的原因、分娩准备、焦虑和担忧程度以及主要照顾者的影响。
290名女性（93.5%）偏好自然阴道分娩；20名女性（6.4%）偏好剖宫产。在后一组中，大多数人目前有产科并发症或曾经历过复杂分娩（p<0.001）；1名女性（0.3%）在没有任何已知的当前或既往产科并发症的情况下偏好剖宫产。偏好剖宫产的女性更焦虑，对该手术风险的了解普遍不足，和/或高估了该手术的安全性。
偏好剖宫产的女性更有可能此前经历过这种分娩方式并对其有负面感受。为了降低女性对剖宫产的偏好，从业者应降低初次剖宫产率，并提高对需要剖宫产的女性的情感护理质量。在有剖宫产史的女性决定后续妊娠的分娩方式之前，护理人员应与她们就包括剖宫产术后阴道分娩在内的各种分娩选择的风险和益处进行敏感的讨论。
