Reproductive Health Unit, Public Health Sciences Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.
BJOG. 2010 Dec;117(13):1608-15. doi: 10.1111/j.1471-0528.2010.02714.x. Epub 2010 Sep 24.
In Bangladesh, the majority of women give birth at home. There is anecdotal evidence that unqualified allopathic practitioners (UAPs) administer oxytocin at home births to augment labour pain. The objective is to explore the use of oxytocin to augment labour pain during home births in an urban slum in Dhaka, Bangladesh.
Cross-sectional survey.
KamrangirChar slum, Dhaka, Bangladesh.
Married women with a home birth or who experienced labour at home in the 6 months prior to the survey (n = 463) were interviewed. Twenty-seven UAPs were interviewed to validate women's responses.
Bivariate and multivariate logistic regressions were used to identify significant predictors of oxytocin use.
Reported use of oxytocin to augment labour pain.
Forty-six percent of women reported using medicine or other treatments to augment labour pain, 131 of whom reported using oxytocin (28% of total). Traditional birth attendants were the predominant decision-makers of when to use oxytocin. The medication was provided by a UAP who administered the drug via saline infusion or intramuscular injection. Higher education, lower parity, reported long labour (more than 12 hours), and knowledge of and positive attitudes towards oxytocin were significantly associated with oxytocin use after controlling for other factors. In the validation exercise, there was agreement about the use of oxytocin to augment labour in 22 of 27 cases (82%).
About one-third of women used oxytocin to augment labour pain. This practice has implications for health education as well as future research to assess the impact on adverse maternal and neonatal outcomes.
在孟加拉国，大多数女性在家中分娩。有传闻证据表明，非专业的顺势疗法医生（UAPs）在家中分娩时会使用催产素来增强分娩疼痛。本研究旨在探讨在孟加拉国达卡市一个城市贫民窟中，在家中分娩时使用催产素来增强分娩疼痛的情况。
横断面调查。
达卡市卡姆兰吉 Char 贫民窟，孟加拉国。
接受过家庭分娩或在调查前 6 个月内在家中经历过分娩的已婚妇女（n=463）接受了访谈。访谈了 27 名 UAPs 以验证妇女的反应。
使用双变量和多变量逻辑回归来确定催产素使用的显著预测因素。
报告使用催产素来增强分娩疼痛。
46%的女性报告使用药物或其他治疗方法来增强分娩疼痛，其中 131 名女性报告使用了催产素（占总数的 28%）。传统的接生员是决定何时使用催产素的主要决策者。药物由 UAP 提供，通过生理盐水输注或肌肉注射给药。受教育程度较高、生育次数较少、报告分娩时间较长（超过 12 小时）以及对催产素的了解和积极态度与控制其他因素后使用催产素显著相关。在验证性研究中，27 例中有 22 例（82%）对使用催产素来增强分娩疼痛的情况达成了一致。
约有三分之一的女性使用催产素来增强分娩疼痛。这种做法对健康教育以及未来评估对母婴不良结局影响的研究都具有重要意义。
