Fenwick Jennifer, Gamble Jenny, Hauck Yvonne
School of Nursing and Midwifery, Curtin University & King Edward Memorial Hospital, Curtin University of Technology, Perth, WA, Australia.
J Clin Nurs. 2007 Aug;16(8):1561-70. doi: 10.1111/j.1365-2702.2006.01747.x.
This study explored the childbirth expectations and knowledge of women who had experienced a caesarean and would prefer a vaginal birth in a subsequent pregnancy.
Vaginal birth after caesarean is considered best practice. However, in most western world countries, despite the inherent risks of caesarean for both mother and baby, the number of women labouring after a previous caesarean is declining.
Newspaper advertisements were used to recruit Western Australian women who had experienced a caesarean. Thematic analysis was used to analyse the interview data collected from women who attempted a vaginal birth (n=24), or stated they would choose this option, in a subsequent pregnancy (n=11).
For this cohort of women, their caesarean experience reinforced their previously held expectations about birthing naturally. The women held strong views about the importance of working with their bodies to achieve a vaginal birth, which was considered an integral part of being a woman and mother. Positive support from family and friends and a reluctance to undergo another caesarean was also influential. Women articulated the risks of caesarean and considered vaginal birth enhanced the health and well-being of the mother and baby, promoted maternal infant connection and the eased the transition to motherhood.
This study documents how the importance of birth, as a significant life event, remained the focus of these women's childbirth expectations influencing future decisions on birth mode and mediating against the 'pressure' of medical discourse promoting caesarean.
Knowledge and appreciation of the multiple dimensions that contribute to women's decisions after a caesarean provides valuable information on which service providers and researchers can draw as they investigate interventions that enhance the uptake and success of women birthing vaginally after a caesarean.
本研究探讨了有剖宫产经历且希望在后续妊娠中顺产的女性的分娩期望和知识。
剖宫产术后阴道分娩被视为最佳做法。然而，在大多数西方国家，尽管剖宫产对母婴存在固有风险，但既往有剖宫产史后选择经阴道分娩的女性数量却在下降。
通过报纸广告招募有剖宫产经历的西澳大利亚女性。采用主题分析法分析从尝试经阴道分娩的女性（n = 24）或表示会在后续妊娠中选择该方式的女性（n = 11）收集到的访谈数据。
对于这组女性而言，她们的剖宫产经历强化了其先前对自然分娩的期望。这些女性坚信配合自身身体条件以实现经阴道分娩至关重要，她们认为这是身为女性和母亲不可或缺的一部分。家人和朋友的积极支持以及不愿再次接受剖宫产也颇具影响。女性阐述了剖宫产的风险，并认为经阴道分娩能增进母婴健康和幸福感，促进母婴情感联结，且有助于顺利过渡到母亲角色。
本研究记录了分娩作为一项重大生活事件的重要性如何仍是这些女性分娩期望的核心，影响着未来分娩方式的决策，并抗衡了主张剖宫产的医学话语的“压力”。
了解并认识到影响剖宫产术后女性决策的多个维度，可为服务提供者和研究人员在调查提高剖宫产术后经阴道分娩的接受率和成功率的干预措施时提供有价值的信息。
