Miron-Shatz Talya, Konheim-Kalkstein Yasmine L
Ono Academic College, Kiryat Ono, Israel.
Winton Centre for Risk and Evidence Communication, University of Cambridge, Cambridge, UK.
J Obstet Gynaecol. 2020 Feb;40(2):171-175. doi: 10.1080/01443615.2019.1606174. Epub 2019 Jul 23.
We evaluated what predicts satisfaction following an unplanned caesarean first-time birth. Two hundred and twenty-seven primiparous women who delivered by unplanned caesarean were surveyed on individual difference variables (the 10-Item Big Five Personality Domains scale, the Desirability for Control Scale), interactional variables (the CollaboRATE scale, and measures of emotional support and decisional inclusion during labour and delivery), perceptions of preparedness, and the Birth Satisfaction Scale-Revised Indicator. A multilinear regression was run using birth satisfaction as the dependent variable. Three variables predicted birth satisfaction: emotional support, being included in the decision-making, and present perception of preparedness (R=.54, <.001). Participants reported feeling more prepared before the birth experience than they actually were, as viewed in hindsight (<.001). How prepared a woman perceives she was for the experience she actually had, together with her perceptions of emotional support and decisional inclusion during birth, predict birth satisfaction when birth deviates from her original expectations.Impact statement An unplanned caesarean often leads to dissatisfaction with the birth experience and is emotionally challenging for women, increasing the risk of postpartum depression and acute stress disorder. Some recent work indicates personality may influence the birth experience, and other work suggests the quality of interaction between healthcare provider and the woman may predict satisfaction. In this study, we sought to identify predictors of satisfaction in women whose first and only birth experience resulted in an unplanned caesarean delivery. Our research demonstrated that over half of the variation in birth satisfaction can be predicted by how prepared women feel they actually were for their experience, by women's perceptions of healthcare providers' efforts made to emotionally support them and to include them in the decision-making process. Personality and a woman's desire for control did not predict satisfaction. These results indicate that birth satisfaction is heavily influenced by what happens before and during the experience and can be amenable by support from a healthcare provider. Preparing women for the possibility of an unplanned caesarean, emotional support, and inclusion in the decision-making process, may reduce dissatisfaction, and potentially distress, after an unplanned caesarean.
我们评估了哪些因素能够预测首次非计划剖宫产分娩后的满意度。对227名通过非计划剖宫产分娩的初产妇进行了调查，内容包括个体差异变量（10项大五人格领域量表、控制欲量表）、互动变量（协作量表以及分娩期间情感支持和决策参与度的测量）、准备程度认知以及分娩满意度量表修订指标。以分娩满意度为因变量进行多元线性回归分析。有三个变量可预测分娩满意度：情感支持、参与决策以及当前的准备程度认知（R = 0.54，P < 0.001）。回顾来看，参与者报告称在分娩经历之前感觉自己比实际准备得更充分（P < 0.001）。当分娩与女性的最初期望不符时，女性对自身实际经历的准备程度认知，以及她在分娩期间对情感支持和决策参与度的认知，能够预测分娩满意度。
非计划剖宫产通常会导致对分娩经历的不满，对女性来说在情感上具有挑战性，增加了产后抑郁和急性应激障碍的风险。最近的一些研究表明人格可能会影响分娩经历，其他研究则表明医疗服务提供者与女性之间的互动质量可能预测满意度。在本研究中，我们试图确定首次且唯一的分娩经历为非计划剖宫产的女性满意度的预测因素。我们的研究表明，分娩满意度超过一半的变异可通过女性对自身实际经历的准备程度感受、女性对医疗服务提供者为给予情感支持和让她们参与决策过程所做努力的认知来预测。人格和女性的控制欲并不能预测满意度。这些结果表明，分娩满意度在很大程度上受到分娩经历之前和期间所发生事情的影响，并且可以通过医疗服务提供者的支持得到改善。让女性为非计划剖宫产的可能性做好准备、给予情感支持以及让她们参与决策过程，可能会降低非计划剖宫产后的不满情绪，并有可能减轻痛苦。
