Munro Sarah, Kornelsen Jude, Hutton Eileen
Sarah Munro, MA, is Editorial Manager at the Centre for Rural Health Research and is a graduate of the University of British Columbia, Vancouver, Canada. She is a doula and breastfeeding consultant and also provides research support for the Centre.Jude Kornelsen, PhD, is Co-Director of the Centre for Rural Health Research, and is Assistant Professor, Department of Family Practice, University of British Columbia, Vancouver, Canada. She is supported by the Canadian Institutes of Health Research New Investigator and Michael Smith Foundation for Health Research Scholar Award Programs. The Centre is also supported by Vancouver Coastal Health Research Institute and the Child and Family Research Institute of British Columbia, Canada.Eileen Hutton, PhD, is Director of the Midwifery Education Program and Assistant Dean in the Faculty of Health Sciences at McMaster University in Hamilton, Ontario, where she is an Associate Professor in the Department of Obstetrics and Gynecology. She is supported by the Canadian Institutes of Health Research New Investigator Award program.
J Midwifery Womens Health. 2009 Sep-Oct;54(5):373-379. doi: 10.1016/j.jmwh.2008.12.014.
Patient-initiated elective cesarean delivery is emerging as an urgent issue for practitioners, hospitals, and policy makers and for pregnant women. This exploratory qualitative study looks at the birth stories and cultural knowledge that women use to inform the decision about an elective cesarean without medical indication. Data collection consisted of exploratory qualitative in-depth interviews with 17 primiparous women in British Columbia, Canada. Interviews revealed the influence of socially circulated birth stories and cultural narratives on their attitudes towards mode of delivery. Participants included in their decision making process both medical information and informal birth stories that were technologically inclined and confirmed their preference for cesarean delivery. Results indicate that women who participated in this study drew heavily from social and cultural knowledge in forming their decision to give birth by patient-initiated elective cesarean delivery. Although the numbers of women who request a cesarean delivery for social reasons is still small, the persuasive influence on parturient women of positive cesarean stories and negative vaginal stories must be considered. Care providers and childbirth educators need to become familiar with the social influences impacting women's decisions for mode of delivery so that truly informed choice discussions can be undertaken.
患者主动要求的择期剖宫产正成为从业者、医院、政策制定者以及孕妇面临的一个紧迫问题。这项探索性定性研究考察了女性用于做出无医学指征的择期剖宫产决定的分娩经历和文化知识。数据收集包括对加拿大不列颠哥伦比亚省17名初产妇进行的探索性定性深入访谈。访谈揭示了社会流传的分娩经历和文化叙事对她们分娩方式态度的影响。参与者在决策过程中纳入了医学信息以及倾向于技术层面且证实她们对剖宫产偏好的非正式分娩经历。结果表明，参与本研究的女性在决定通过患者主动要求的择期剖宫产分娩时，很大程度上借鉴了社会和文化知识。尽管因社会原因要求剖宫产的女性数量仍然较少，但必须考虑剖宫产正面经历和阴道分娩负面经历对产妇的说服性影响。护理人员和分娩教育工作者需要熟悉影响女性分娩方式决定的社会因素，以便能够进行真正意义上的知情选择讨论。
