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“压力、愤怒、恐惧与不公”:一项关于女性计划臀位阴道分娩经历的国际定性调查

'Stress, anger, fear and injustice': An international qualitative survey of women's experiences planning a vaginal breech birth.

作者信息

Petrovska Karolina, Watts Nicole P, Catling Christine, Bisits Andrew, Homer Caroline Se

机构信息

Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Level 7, 235 Jones St, Ultimo NSW 2007 (PO Box 123), Sydney, Australia.

Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Level 7, 235 Jones St, Ultimo NSW 2007 (PO Box 123), Sydney, Australia.

出版信息

Midwifery. 2017 Jan;44:41-47. doi: 10.1016/j.midw.2016.11.005. Epub 2016 Nov 21.

Abstract

OBJECTIVE

the outcomes of the Term Breech Trial had a profound impact on women's options for breech birth, with caesarean section now seen as the default method for managing breech birth by many clinicians. Despite this, the demand for planned vaginal breech birth from women does exist. This study aimed to examine the experiences of women who sought a vaginal breech birth to increase understanding as to how to care for women seeking this birth option.

DESIGN

an electronic survey was distributed to women online via social media. The survey consisted of qualitative and quantitative questions, with the qualitative data being the focus of this paper. Open ended questions sought information on the ways in which woman sourced a clinician skilled in vaginal breech birth and the level of support and quality of information provided from clinicians regarding vaginal breech birth. Thematic analysis was used to analyse and code the qualitative data into major themes.

FINDINGS

in total, 204 women from over seven countries responded to the survey. Written responses to the open ended questions were categorised into seven themes: Seeking the chance to try for a VBB; Encountering coercion and fear; Putting the birth before the baby?; Dealing with emotional wounds; Searching for information and support; Traveling across boundaries; Overcoming obstacles in the system.

KEY CONCLUSIONS

for women seeking vaginal breech birth, limited system and clinical support can impede access to balanced information and options for care. Recognition of existing evidence on the safety of vaginal breech birth, as well as the presence of clinical guidelines that support it, may assist in promoting vaginal breech birth as a legitimate option that should be available to women.

摘要

目的

足月臀位分娩试验的结果对女性臀位分娩的选择产生了深远影响,如今许多临床医生将剖宫产视为处理臀位分娩的默认方法。尽管如此,女性对计划阴道臀位分娩的需求确实存在。本研究旨在调查寻求阴道臀位分娩的女性的经历,以增进对如何护理选择这种分娩方式的女性的理解。

设计

通过社交媒体向女性在线发放电子调查问卷。该问卷包含定性和定量问题,本文重点关注定性数据。开放式问题旨在获取有关女性如何找到擅长阴道臀位分娩的临床医生的信息,以及临床医生提供的关于阴道臀位分娩的支持水平和信息质量。采用主题分析法对定性数据进行分析并编码为主要主题。

结果

来自七个以上国家的204名女性回复了该调查。对开放式问题的书面回答被归类为七个主题:寻求尝试阴道臀位分娩的机会;遭遇强制和恐惧;将分娩置于婴儿之前?;处理情感创伤;寻找信息和支持;跨越边界;克服系统中的障碍。

主要结论

对于寻求阴道臀位分娩的女性,有限的系统和临床支持可能会阻碍她们获得平衡的信息和护理选择。认识到关于阴道臀位分娩安全性的现有证据以及支持它的临床指南的存在,可能有助于将阴道臀位分娩推广为女性应可选择的合法方式。

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