Christiaens Wendy, Bracke Piet
Ghent University, Department of Sociology, Korte Meer 5, 9000 Ghent, Belgium.
Midwifery. 2009 Apr;25(2):e11-9. doi: 10.1016/j.midw.2007.02.001. Epub 2007 May 18.
to gain insight into the association between satisfaction with childbirth and place of birth, in the context of two maternity-care systems, in Belgium and the Netherlands. The Belgian and Dutch societies have many similarities but differ in the organisation of maternity care. The Dutch way of giving birth is well known for its high percentage of home births and its low medical intervention rate. In contrast, home births in Belgium are uncommon and the medical model is taken for granted.
quantitative, comparative study using questionnaires to assess satisfaction with childbirth.
hospitals and independent midwifery practices in two comparable cities in Belgium and the Netherlands.
two questionnaires were completed by 611 women, one at 30 weeks of pregnancy and one within the first 2 weeks after childbirth, at home or in hospital. The women were invited to participate in the study by independent midwives and obstetricians during prenatal visits between 2004 and 2005.
satisfaction with childbirth was measured by the Mackey Satisfaction with Childbirth Rating Scale, which takes into account the multi-dimensional nature of the concept. An analysis of variance with two fixed factors, planned place of birth and maternity-care system, shows that women who had planned for a home birth were more satisfied than women who had planned for a hospital birth. This was true in every subdimension of satisfaction. Belgian women were more satisfied with childbirth than their northern neighbours, in every subdimension. The higher satisfaction scores of the Belgian women accounted for both home and hospital births.
women who had planned a home birth were the most satisfied (in both countries), but Belgian women had higher satisfaction scores than Dutch women. This is paradoxical because a non-medical home context has a beneficial effect on satisfaction, whereas the Dutch non-interventionist approach in maternity care does not yield the same effect.
medicalisation critics may be right about the iatrogenic effects of the medical approach on an individual level, but other social forces operate on the level of maternity-care systems.
在比利时和荷兰两种孕产妇保健系统的背景下，深入了解分娩满意度与出生地之间的关联。比利时和荷兰社会有许多相似之处，但在孕产妇保健的组织方式上存在差异。荷兰的分娩方式以高比例的家庭分娩和低医疗干预率而闻名。相比之下，比利时的家庭分娩并不常见，医疗模式被视为理所当然。
采用问卷调查进行定量比较研究，以评估分娩满意度。
比利时和荷兰两个可比城市的医院和独立助产士诊所。
611名女性完成了两份问卷，一份在怀孕30周时填写，另一份在产后前两周内在家中或医院填写。这些女性是在2004年至2005年期间，由独立助产士和产科医生在产前检查时邀请参与该研究的。
采用麦基分娩满意度评定量表来测量分娩满意度，该量表考虑了这一概念的多维度性质。对两个固定因素（计划分娩地点和孕产妇保健系统）进行方差分析表明，计划在家分娩的女性比计划在医院分娩的女性更满意。在满意度的每个子维度中都是如此。在每个子维度中，比利时女性对分娩的满意度都高于其北方邻国的女性。比利时女性较高的满意度得分在家庭分娩和医院分娩中均有体现。
计划在家分娩的女性最满意（在两个国家都是如此），但比利时女性的满意度得分高于荷兰女性。这是自相矛盾的，因为非医疗的家庭环境对满意度有有益影响，而荷兰在孕产妇保健方面的非干预主义方法并未产生同样的效果。
医疗化批评者在医疗方法对个体层面的医源性影响方面可能是正确的，但其他社会力量在孕产妇保健系统层面发挥作用。
