Mid Sweden Research & Development Centre, Västernorrland County Council, Sundsvall SE-851 86, Sweden.
Midwifery. 2011 Oct;27(5):620-7. doi: 10.1016/j.midw.2010.05.005. Epub 2010 Jul 13.
to describe the prevalence of women's preference for caesarean section as expressed in mid pregnancy, late pregnancy and one year post partum. An additional aim was to identify associated factors and investigate reasons for the preference.
mixed methods. Data were collected from 2007 to 2008 through questionnaires distributed to a Swedish regional cohort of women. The survey was part of a longitudinal study of women's attitudes and beliefs related to childbirth. One open question regarding the reasons for the preferred mode of birth was analysed using content analysis.
three hospitals in the county of Västernorrland in the middle of Sweden.
1506 women were recruited at the routine ultrasound screening during weeks 17 to 19 of their pregnancy.
a preference for caesarean section was stated by 7.6% of women during mid pregnancy and by 7.0% in late pregnancy. One year post partum 9.8% of the women stated that they would prefer a caesarean section if they were to have another baby. This was related to their birth experience. There were more multiparous women who wished for a caesarean section. Associated factors irrespective of parity were fear of giving birth and a 'strongly disagree' response to the statement regarding that the preferred birth should be as natural as possible. Among multiparous women the strongest predictors were previous caesarean sections, particularly those that were elective, and a previous negative birth experience. Women's comments on their preferred mode of birth revealed five categories: women described caesarean section as their only option relating to obstetrical and/or medical factors; several women stated ambivalent feelings and almost as many described their previous birthing experiences as a reason to prefer a caesarean birth; childbirth-related fear and caesarean section as a safe option were the remaining categories.
rising caesarean section rates seem to be related to factors other than women's preferences. Ambivalence towards a way of giving birth is common during pregnancy. This should be of concern for midwives and obstetricians during antenatal care. Information and counselling should be frequent and comprehensive when a discussion on caesarean section is initiated by the pregnant woman. A negative birth experience is related to a future preference for caesarean section and this should be considered by caregivers providing intrapartum care.
描述孕妇在妊娠中期、妊娠晚期和产后一年表达对剖宫产的偏好的流行情况。另一个目的是确定相关因素并探讨偏好的原因。
混合方法。数据于 2007 年至 2008 年通过向瑞典中部韦斯特兰地区的女性队列发放问卷收集。该调查是一项关于女性对分娩的态度和信念的纵向研究的一部分。对与首选分娩方式相关的一个开放式问题使用内容分析进行了分析。
瑞典中部韦斯特兰县的三家医院。
在妊娠 17 至 19 周的常规超声筛查中招募了 1506 名女性。
妊娠中期有 7.6%的女性表示偏爱剖宫产，妊娠晚期有 7.0%的女性表示偏爱剖宫产。产后一年，9.8%的女性表示如果再次生育，她们会选择剖宫产。这与她们的分娩经历有关。有更多的多产妇希望进行剖宫产。与产次无关的相关因素是对分娩的恐惧和对“首选分娩应尽可能自然”这一说法的强烈反对。在多产妇中，预测力最强的是以前的剖宫产，特别是那些选择性剖宫产和以前的负面分娩经历。女性对首选分娩方式的评论揭示了五个类别：女性将剖宫产描述为与产科和/或医学因素相关的唯一选择；一些女性表示犹豫不决，几乎同样多的女性将她们以前的分娩经历描述为偏爱剖宫产的原因；与分娩相关的恐惧和剖宫产是安全选择是其余的类别。
剖宫产率的上升似乎与女性偏好以外的因素有关。在怀孕期间，对分娩方式的矛盾态度很常见。这应该引起助产士和产科医生在产前保健中的关注。当孕妇开始讨论剖宫产时，应频繁且全面地提供信息和咨询。负面的分娩经历与未来对剖宫产的偏好有关，这应该是提供产时护理的医护人员所考虑的。
