[The psychosocial aspects of perinatal care and their relationship to selected medical interventions and health complications during parturition].

OBJECTIVE

Find association between psychosocial factors of perinatal care and selected childbirth complications and interventions.

DESIGN

Original study.

SETTING

Department of Psychology, Faculty of Arts and Philosophy, Charles University, Prague.

METHODS

Statistical data analysis of questionnaire survey of low-risk parturients (n=657) was carried out. Respondents were divided into experimental groups (EG) according to experienced interventions and complications (hemorrhage, failure to progress, fetal distress, forceps/VEX delivery, caesarean birth, failure to progress followed by caesarean birth, labour acceleration infusion, other infusion, epidural anesthesia, other form of pharmacological analgesia, episiotomy, amniotomy). EG were compared with a control group (CG) of women with no complications and interventions (n=107) in evaluation of psychosocial factors of perinatal care (healthcare provider attitude; control; communication; woman-friendliness of hospital rules) and physical comfort and services, presence of other persons at birth, prevailing emotional reaction and overall satisfaction with maternity care. The interpretation of results draws from qualitative analysis of open-ended question answers.

RESULTS

EG and CG differed significantly in control (all EGs scored lower) and healthcare provider attitude evaluation (significantly more negative perception at EGs: hemorrhage, failure to progress, fetal distress, forceps/VEX delivery, labour acceleration infusion, episiotomy). Significant differences were noted also for woman-friendliness of hospital rules (lower scores for EGs: hemorrhage, failure to progress, failure to progress followed by caesarean birth) and for presence of other persons at birth. Possible interpretations of the above results are discussed.

CONCLUSION

Psychosocial factors of perinatal care constitute important childbirth process determinants, while playing a key role for parturients ability to cope with anxiety and stress connected with childbirth complications and interventions. Beneficial psychosocial climate of a hospital contributes to higher patient satisfaction as well as to lower maternal and neonatal morbidity.