Halvorsen Lotta, Nerum Hilde, Øian Pål, Sørlie Tore
Kvinneklinikken Universitetssykehuset Nord-Norge Postboks 100 9038 Tromsø.
Tidsskr Nor Laegeforen. 2008 Jun 12;128(12):1388-91.
Caesarean section rates have increased in Norway, as in the rest of the western world since the beginning of the 1970s, and further explanations are needed to understand this development. The study aimed to examine whether demographic or psychological burdens differed among women who feared childbirth, according to whether or not they requested caesarean section.
In the period 2000-02, 164 pregnant women who feared childbirth were referred for counselling with two midwives (specialized in mental health) at the antenatal clinic at the University Hospital of North Norway. Data were retrieved from counselling sessions, referral letters, antenatal and intrapartum care records. The group that wished to have caesarean sections (n = 86) was compared with the one that did not (n = 78).
80% of the women had previously experienced anxiety and/or depression, 32% had eating disturbances and 72% reported having been abused. In the group requesting caesarean section the women had more severe fear of childbirth, previous traumatic birth experiences, previous anxiety and depression, lack of confidence in the professional staff and fewer had been treated for their psychological problems. At the onset of labour, 86% who initially requested a caesarean delivery were prepared for a vaginal birth. The overall caesarean rate for both groups was 32%.
The women who feared childbirth generally had a larger burden of psychosocial and psychiatric problems than others, and those who requested a caesarean delivery had most. Charting and processing these burdens is presumably of significance for the birth outcome.
自20世纪70年代初以来，挪威的剖宫产率一直在上升，与西方世界其他国家一样，需要进一步解释这一发展趋势。本研究旨在探讨害怕分娩的女性中，根据是否要求剖宫产，其人口统计学或心理负担是否存在差异。
在2000 - 2002年期间，164名害怕分娩的孕妇被转介到挪威北部大学医院产前诊所，由两名（专门从事心理健康工作的）助产士进行咨询。数据从咨询记录、转诊信、产前和产时护理记录中获取。将希望进行剖宫产的组（n = 86）与不希望进行剖宫产的组（n = 78）进行比较。
80%的女性曾经历过焦虑和/或抑郁，32%有饮食失调问题，72%报告曾遭受虐待。在要求剖宫产的组中，女性对分娩的恐惧更严重，有过创伤性分娩经历，有过焦虑和抑郁，对专业人员缺乏信心，且接受心理问题治疗的人数较少。临产时，最初要求剖宫产的女性中有86%准备顺产。两组的总体剖宫产率均为32%。
害怕分娩的女性通常比其他人承担着更大的社会心理和精神问题负担，而要求剖宫产的女性负担最重。梳理和处理这些负担可能对分娩结局具有重要意义。
