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美国医疗和助产学模式下分娩中女性对分娩疼痛的期望和体验。

Women's expectations and experiences with labour pain in medical and midwifery models of birth in the United States.

机构信息

University of South Carolina Department of Anthropology, 1512 Pendleton St., Hamilton College, 317, Columbia, SC 29208, USA.

出版信息

Women Birth. 2014 Sep;27(3):185-9. doi: 10.1016/j.wombi.2014.05.002. Epub 2014 Jun 2.

Abstract

BACKGROUND

This research focuses on how women understand and experience labour as related to two competing views of childbirth pain. The biomedical view is that labour pain is abnormal and anaesthesia/analgesia use is encouraged to relieve the pain. The midwifery view is that pain is a normal part of labour that should be worked with instead of against.

AIMS

To determine differences in the preparation for and experiences with labour pain by women choosing midwives versus obstetricians.

METHODS

Prenatal and postpartum in-depth semi-structured interviews were conducted with a convenience sample of 80 women in Florida (United States): 40 who had chosen an obstetrician and 40 who had chosen a licensed midwife as their birth practitioner.

FINDINGS

Women in both groups were concerned with the pain of childbirth before and after their labour experiences. Women choosing midwives discussed preparing for pain through various non-pharmaceutical coping methods, while women choosing physicians discussed pharmaceutical and non-pharmaceutical pain relief.

CONCLUSIONS

Equal numbers of women expressed concerns with childbirth pain during the prenatal interviews, while more women choosing doctors spoke about pain after their births. Women had negative experiences when their planned pain relief method, either natural or medical, did not occur. The quandary facing women when it comes to labour pain relief is not choosing what they desire, but rather preparing themselves for the possibility that they may have to accept alternatives to their original preferences.

摘要

背景

本研究关注女性如何理解和体验分娩疼痛,以及两种相互竞争的分娩疼痛观点。生物医学观点认为分娩疼痛是异常的,应鼓励使用麻醉/镇痛来缓解疼痛。助产士观点则认为疼痛是分娩的正常部分,应该与疼痛作斗争,而不是对抗疼痛。

目的

确定选择助产士和产科医生的女性在分娩疼痛准备和体验方面的差异。

方法

对佛罗里达州(美国)的 80 名女性进行了产前和产后深入的半结构化访谈:40 名选择了产科医生,40 名选择了持照助产士作为分娩医生。

发现

两组女性在分娩前和分娩后都对分娩疼痛感到担忧。选择助产士的女性通过各种非药物应对方法来准备应对疼痛,而选择医生的女性则讨论了药物和非药物的止痛方法。

结论

在产前访谈中,同样数量的女性对分娩疼痛表示担忧,而更多选择医生的女性则在分娩后谈论疼痛。当女性计划的止痛方法,无论是自然的还是医学的,都没有实现时,她们会有负面的体验。女性在分娩疼痛缓解方面面临的困境不是选择她们想要的方法,而是要为可能不得不接受与最初偏好不同的替代方法做好准备。

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