Latifnejad-Roudsari Robab, Zakerihamidi Maryam, Merghati-Khoei Effat, Kazemnejad Anoshirvan
Research Center for Patient Safety, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Nurs Midwifery Res. 2014 Feb;19(7 Suppl 1):S28-36.
Data was reported in Iran in 2013 has shown that almost 42 percent of deliveries in public hospitals and 90 percent in private hospitals were carried out with cesarean section. This high rate of cesarean requires careful consideration. It seems that making decision for cesarean is done under the influence of cultural perceptions and beliefs. So, this study was conducted to explore pregnant women's preferences and perceptions regarding cesarean delivery.
A focused ethnographic study was used. 12 pregnant women and 10 delivered women, seven midwives, seven gynecologist and nine non-pregnant women referred to the health clinics of Tonekabon, who selected purposively, were included in the study. To collect data semi-structured in-depth interviews and participant observation were used. Study rigor was confirmed through prolonged engagement, member check, expert debriefing, and thick description of the data. Data were analysed using thematic analysis and MAXQDA software.
Four themes emerged from the data including personal beliefs, fear of vaginal delivery, cultural norms and values and also social network. These concepts played main roles in how women develop meanings toward caesarean, which affected their perceptions and preferences in relation to caesarean delivery.
Most of pregnant women believed that fear of vaginal delivery is a major factor to choose caesarean delivery. Hence, midwives and physicians could help them through improving the quality of prenatal care and giving them positive perception towards vaginal delivery through presenting useful information about the nature of different modes of delivery, and their advantages and disadvantages, as well as the alternative ways to control labor pain.
2013年伊朗公布的数据显示,公立医院近42%的分娩以及私立医院90%的分娩是剖宫产。如此高的剖宫产率需要谨慎考虑。剖宫产决策似乎是在文化观念和信仰的影响下做出的。因此,本研究旨在探讨孕妇对剖宫产的偏好和看法。
采用聚焦民族志研究方法。本研究纳入了12名孕妇、10名已分娩女性、7名助产士、7名妇科医生以及9名非孕妇,这些人员均为有目的地选取,来自通卡本的健康诊所。通过半结构化深度访谈和参与观察来收集数据。通过长期参与、成员核对、专家汇报以及对数据的详细描述来确保研究的严谨性。使用主题分析和MAXQDA软件对数据进行分析。
数据中出现了四个主题,包括个人信念、对阴道分娩的恐惧、文化规范和价值观以及社交网络。这些概念在女性如何形成对剖宫产的认知方面发挥了主要作用,进而影响了她们对剖宫产的看法和偏好。
大多数孕妇认为,对阴道分娩的恐惧是选择剖宫产的主要因素。因此,助产士和医生可以通过提高产前护理质量,向她们提供有关不同分娩方式的性质、优缺点以及控制分娩疼痛的替代方法等有用信息,帮助她们对阴道分娩形成积极的认知。