Rijnders Marlies, Baston Helen, Schönbeck Yvonne, van der Pal Karin, Prins Marianne, Green Josephine, Buitendijk Simone
TNO Quality of Life, Leiden, The Netherlands.
Birth. 2008 Jun;35(2):107-16. doi: 10.1111/j.1523-536X.2008.00223.x.
Little research has been conducted to date on women's postnatal emotional well-being and satisfaction with the care received in the Netherlands. The aim of this study was to investigate Dutch women's views of their birth experience 3 years after the event.
A questionnaire was mailed to all women who had given birth in 2001 and who had at least one prenatal, perinatal, or postnatal visit to the participating midwifery practice. Women who had a subsequent birth after the index birth in 2001 were not excluded. We specifically asked respondents to reflect on the birth that occurred in 2001. Women were asked to say how they felt now looking back on their labor and birth, with five response options from "very happy" to "very unhappy."
We received 1,309 postnatal questionnaires (response rate 44%). The sample was fairly representative with respect to the mode of delivery, place of birth, and obstetric interventions compared with the total Dutch population of pregnant women; however, the sample was not representative for ethnicity and initial caregiver. Three years after delivery, most women looked back positively on their birth experience, but more than 16 percent looked back negatively. More than 1 in 5 primiparas looked back negatively compared with 1 in 9 multiparas. Adjusted odds ratios (OR) for looking back negatively 3 years later included having had an assisted vaginal delivery or unplanned cesarean delivery (OR 2.6, 95% CI 1.59-4.14), no home birth (OR 1.4, 95% CI 1.04-1.93), referral during labor (OR 2.4, 95% CI 1.48-3.77), not having had a choice in pain relief (OR 2.9, 95% CI 1.91-4.45), not being satisfied in coping with pain (OR 4.9, 95% CI 2.55-9.40), a negative description of the caregivers (OR 2.9, 95% CI 1.85-4.40), or having had fear for the baby's life or her own life (OR 2.3, 95% CI 1.47-3.48).
A substantial proportion of Dutch women looked back negatively on their birth experience 3 years postpartum. Further research needs to be undertaken to understand women's expectations and experiences of birth within the Dutch maternity system and an examination of maternity care changes designed to reduce or modify controllable factors that are associated with negative recall.
迄今为止，关于荷兰女性产后情绪健康状况以及对所接受护理的满意度的研究较少。本研究旨在调查荷兰女性在分娩事件发生3年后对其分娩经历的看法。
向所有在2001年分娩且至少有一次产前、围产期或产后就诊于参与研究的助产机构的女性邮寄问卷。2001年首次分娩后又有后续分娩的女性不被排除。我们特别要求受访者回顾2001年发生的那次分娩。询问女性现在回顾自己的分娩过程时有何感受，有从“非常开心”到“非常不开心”的五个回答选项。
我们收到了1309份产后问卷（回复率44%）。与荷兰孕妇总体相比，该样本在分娩方式、分娩地点和产科干预方面具有相当的代表性；然而，该样本在种族和最初护理人员方面不具有代表性。分娩三年后，大多数女性对自己的分娩经历持积极回顾态度，但超过16%的女性持消极态度。超过五分之一的初产妇持消极回顾态度，而经产妇中这一比例为九分之一。三年后持消极回顾态度的调整后优势比（OR）包括进行过助产阴道分娩或非计划剖宫产（OR 2.6，95%置信区间1.59 - 4.14）、未在家分娩（OR 1.4，95%置信区间1.04 - 1.93）、分娩期间转诊（OR 2.4，95%置信区间1.48 - 3.77）、在疼痛缓解方面没有选择（OR 2.9，95%置信区间1.91 - 4.45）、对疼痛应对不满意（OR 4.9，95%置信区间2.55 - 9.40）、对护理人员有负面描述（OR 2.9，95%置信区间1.85 - 4.40）或对婴儿生命或自身生命感到恐惧（OR 2.3，95%置信区间1.47 - 3.48）。
相当一部分荷兰女性在产后三年对自己的分娩经历持消极回顾态度。需要进一步开展研究，以了解荷兰孕产妇系统中女性的分娩期望和经历，并审视旨在减少或改变与负面回忆相关的可控因素的孕产妇护理变化。
