Stoll Kathrin H, Hauck Yvonne L, Hall Wendy A
School of Population & Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC V6T-1Z3, Canada.
School of Nursing and Midwifery, Curtin University, Perth, WA 6845, Australia; Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Bagot Road, Subiaco, WA 6008, Australia.
Women Birth. 2016 Feb;29(1):e33-8. doi: 10.1016/j.wombi.2015.07.187. Epub 2015 Aug 28.
Australian caesarean birth rates have exceeded 30% in most states and are approaching 45%, on average, in private hospitals. Australian midwifery practice occurs almost exclusively in hospitals; less than 3% of women deliver at home or in birthing centres. It is unclear whether the trend towards hospital-based, high interventionist birth reflects preferences of the next generation of maternity care consumers.
We conducted a descriptive cross-sectional online survey of 760 Western Australian (WA) university students in 2014, to examine their preferences for place of birth, type of maternity care, mode of birth and attitudes towards birth.
More students who preferred midwives (35.8%) had vaginal birth intentions, contested statements that birth is unpredictable and risky, and valued patient-provider relationships. More students who preferred obstetricians (21.8%) expressed concerns about childbirth safety, feared birth, held favourable views towards obstetric technology, and expressed concerns about the impact of pregnancy and birth on the female body. One in 8 students preferred out-of-hospital birth settings, supporting consumer demand for midwife-attended births at home and in birthing centres. Stories and experiences of friends and family shaped students' care provider preferences, rather than the media or information learned at school.
Students who express preferences for midwives have significantly different views about birth compared to students who prefer obstetricians. Increasing access to midwifery care in all settings (hospital, birthing centre and home) is a cost effective strategy to decrease obstetric interventions for low risk women and a desirable option for the next generation.
在澳大利亚的大多数州，剖宫产率已超过30%，在私立医院平均接近45%。澳大利亚的助产实践几乎完全在医院进行；不到3%的女性在家中或分娩中心分娩。尚不清楚以医院为基础的、高干预性分娩趋势是否反映了下一代产妇护理消费者的偏好。
2014年，我们对760名西澳大利亚（WA）大学生进行了一项描述性横断面在线调查，以研究他们对分娩地点、产妇护理类型、分娩方式的偏好以及对分娩的态度。
更多倾向于助产士的学生（35.8%）有顺产意愿，对“分娩不可预测且有风险”的说法提出质疑，并重视医患关系。更多倾向于产科医生的学生（21.8%）表达了对分娩安全的担忧，害怕分娩，对产科技术持积极看法，并对怀孕和分娩对女性身体的影响表示担忧。八分之一的学生倾向于院外分娩环境，支持消费者对在家中和分娩中心由助产士接生的需求。朋友和家人的故事及经历影响了学生对护理提供者的偏好，而非媒体或在学校学到的信息。
与倾向于产科医生的学生相比，倾向于助产士的学生对分娩的看法有显著差异。在所有环境（医院、分娩中心和家庭）中增加助产护理的可及性，是降低低风险女性产科干预的一种具有成本效益的策略，也是下一代的理想选择。
