Health Economics Research Unit, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
Birth. 2011 Mar;38(1):36-46. doi: 10.1111/j.1523-536X.2010.00447.x. Epub 2010 Dec 23.
The latent phase of labor can vary greatly in duration, and many women are uncertain about when to contact the maternity unit. The aim of this study was to elicit and value women's preferences for some aspects of labor management.
A questionnaire was sent to 1,251 women who had recently given birth to their first child at one of 14 maternity units in Scotland. Discrete choice questions were used to measure women's preferences for five attributes of care: number of visits (assessments) before admission to the labor ward, time spent on the labor ward before delivery, mobility during labor, pain relief required, and mode of delivery. Responses were analyzed for the sample as a whole and for subgroups defined by recent experiences of labor.
A total of 730 (58.4%) questionnaires were returned and analyzed. Women expressed a preference for fewer visits before admission, shorter times on the labor ward before delivery, mobility during labor, normal vaginal deliveries, and moderate forms of pain relief (Entonox and opiates). Subgroup analysis suggests that women's preferences for pain relief are influenced by their recent labor experience. The elicited preference values provide a means for estimating the tradeoffs women are willing to make between attributes of labor management.
Women appear to dislike being turned away from the labor ward before admission for delivery. Extra visits before admission only appear to be a price worth paying if they result in reductions in the duration of time spent on the labor ward, reductions in the chance of being immobilized in hospital during labor, or a lower chance of requiring an instrumental or operative delivery.
分娩潜伏期的持续时间差异很大，许多女性不确定何时联系产科病房。本研究旨在了解并评估女性对分娩管理某些方面的偏好。
向 14 家苏格兰产科病房最近分娩第一胎的 1251 名女性发送了一份问卷。使用离散选择问题来衡量女性对护理五个属性的偏好：入院前的访视次数（评估）、进入产房前在产房的停留时间、分娩时的活动能力、所需的止痛方式和分娩方式。对整个样本和按最近分娩经历定义的亚组进行了响应分析。
共收回并分析了 730 份（58.4%）问卷。女性表示希望在入院前的访视次数更少、进入产房前的停留时间更短、分娩时的活动能力更强、正常阴道分娩和中度止痛（Entonox 和阿片类药物）。亚组分析表明，女性对止痛方式的偏好受到其近期分娩经历的影响。得出的偏好值提供了一种估计女性愿意在分娩管理属性之间进行权衡的方法。
女性似乎不喜欢在入院分娩前被拒绝进入产房。只有在额外的入院前访视能够减少在产房的停留时间、减少在医院分娩时被固定的机会或降低需要器械或手术分娩的机会的情况下，这些额外的访视才是值得的。
