Alehagen Siw, Wijma Barbro, Wijma Klaas
Division of Nursing, Department of Medicine and Care, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden.
Acta Obstet Gynecol Scand. 2006;85(1):56-62. doi: 10.1080/00016340500334844.
Only scanty research exists about the relationship between women's expectations during pregnancy and their experiences as reported during the actual process of labor and afterwards. The aims of the present study were: (1) to investigate the associations between fear of childbirth during pregnancy and postpartum and fear and pain during early active labor (phase 1: cervix dilatation 3-5 cm), and (2) to explore possible differences regarding fear of childbirth during pregnancy and postpartum between women who did or did not receive epidural analgesia during labor. Methods. Fear of childbirth was measured in 47 nulliparous women during gestation weeks 37-39 by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ version A). During early active labor we measured women's fear (Delivery Fear Scale) and their experiences of pain (a pain intensity scale). Finally, fear after childbirth (W-DEQ version B) was measured two hours, two days, and five weeks after delivery.
A positive correlation appeared between fear of childbirth during pregnancy, postpartum, and early active labor. There were no differences in fear of childbirth during late pregnancy between women who received epidural analgesia and those who did not. Postpartum fear was higher in the women who had received epidural analgesia.
Pregnant women who fear childbirth are prone to report fear during the actual labor and postpartum. The administration of epidural analgesia is not a sufficient response to women's fear during the process of labor.
关于孕期女性的期望与她们在实际分娩过程及产后所报告的经历之间的关系,现有研究甚少。本研究的目的是:(1)调查孕期和产后的分娩恐惧与早期活跃期分娩(第1阶段:宫颈扩张3 - 5厘米)时的恐惧和疼痛之间的关联,以及(2)探讨分娩时接受或未接受硬膜外镇痛的女性在孕期和产后分娩恐惧方面可能存在的差异。方法。在妊娠第37 - 39周时,通过Wijma分娩期望/体验问卷(W - DEQ A版)对47名初产妇的分娩恐惧进行测量。在早期活跃期分娩时,我们测量了女性的恐惧(分娩恐惧量表)和她们的疼痛体验(疼痛强度量表)。最后,在分娩后两小时、两天和五周测量产后恐惧(W - DEQ B版)。
孕期、产后和早期活跃期分娩时的分娩恐惧之间呈正相关。接受硬膜外镇痛的女性与未接受硬膜外镇痛的女性在妊娠晚期的分娩恐惧方面没有差异。接受硬膜外镇痛的女性产后恐惧更高。
害怕分娩的孕妇在实际分娩和产后更容易报告恐惧。硬膜外镇痛的使用并不能充分应对女性在分娩过程中的恐惧。