分娩技术与产妇在分娩中的角色：首次临近分娩的加拿大女性的知识与态度

Birth technology and maternal roles in birth: knowledge and attitudes of canadian women approaching childbirth for the first time.

作者信息

Klein Michael C, Kaczorowski Janusz, Hearps Stephen J C, Tomkinson Jocelyn, Baradaran Nazli, Hall Wendy A, McNiven Patricia, Brant Rollin, Grant Jalana, Dore Sharon, Brasset-Latulippe Anne, Fraser William D

机构信息

Developmental Neuroscience and Child Health, Child and Family Research Institute, University of British Columbia, Vancouver BC; Department of Family Practice, University of British Columbia, Vancouver BC; Department of Pediatrics, University of British Columbia, Vancouver BC.

出版信息

J Obstet Gynaecol Can. 2011 Jun;33(6):598-608. doi: 10.1016/S1701-2163(16)34908-8.

DOI:10.1016/S1701-2163(16)34908-8

PMID:21846449

Abstract

OBJECTIVE

To describe Canadian nulliparous women's attitudes to birth technology and their roles in childbirth.

METHODS

A large convenience sample of low-risk women expecting their first birth was recruited by posters in laboratories, at the offices of obstetricians, family physicians, and midwives, at prenatal classes, and through web-based advertising and invited to complete a paper or web-based questionnaire.

RESULTS

Of the 1318 women completing the questionnaire, 95% did so via the web-based method; 13.2% of respondents were in the first trimester, 39.8% were in the second trimester, and 47.0% in the third. Overall, 42.6% were under the care of an obstetrician, 29.3% a family physician, and 28.1% a registered midwife. The sample included mainly well-educated, middle-class women. The planned place of giving birth ranged from home to hospital, and from rural centres to large city hospitals. Eighteen percent planned to engage a doula. Women attending obstetricians reported attitudes more favourable to the use of birth technology and less supportive of women's roles in their own delivery, regardless of the trimester in which the survey was completed. Those women attending midwives reported attitudes less favourable to the use of technology at delivery and more supportive of women's roles. Family practice patients' opinions fell between the other two groups. For eight of the questions, "I don't know" (IDK) responses exceeded 15%. These IDK responses were most frequent for questions regarding risks and benefits of epidural analgesia, Caesarean section, and episiotomy. Women in the care of midwives consistently used IDK options less frequently than those cared for by physicians.

CONCLUSIONS

Regardless of the type of care provider they attended, many women reported uncertainty about the benefits and risks of common procedures used at childbirth. When grouped by the type of care provider, in all trimesters, women held different views across a range of childbirth issues, suggesting that the three groups of providers were caring for different populations with different attitudes and expectations.

摘要

目的

描述加拿大未生育女性对分娩技术的态度及其在分娩中的角色。

方法

通过在实验室张贴海报、在产科医生、家庭医生和助产士办公室、产前课程以及通过网络广告，招募了大量预期首次分娩的低风险女性作为便利样本，并邀请她们完成纸质或网络问卷。

结果

在完成问卷的1318名女性中，95%是通过网络方式完成的；13.2%的受访者处于孕早期，39.8%处于孕中期，47.0%处于孕晚期。总体而言，42.6%的女性由产科医生护理，29.3%由家庭医生护理，28.1%由注册助产士护理。样本主要包括受过良好教育的中产阶级女性。计划分娩地点从家中到医院，从农村中心到大城市医院。18%的人计划聘请导乐。无论调查是在哪个孕期完成的，就诊于产科医生的女性对使用分娩技术的态度更为支持，而对女性在自身分娩中的角色支持较少。那些就诊于助产士的女性对分娩时使用技术的态度不太支持，对女性角色的支持更多。家庭医生的患者意见介于其他两组之间。对于其中8个问题，“我不知道”（IDK）的回答超过了15%。这些IDK回答在关于硬膜外镇痛、剖宫产和会阴切开术的风险和益处的问题中最为常见。由助产士护理的女性使用IDK选项的频率始终低于由医生护理的女性。