Ryan Gillian, O Doherty Kate C, Devane Declan, McAuliffe Fionnuala, Morrison John
Department of Obstetrics and Gynaecology, National University of Ireland, Galway, Ireland
Department of Obstetrics and Gynaecology, Galway University Hospitals, Galway, Ireland.
BMJ Open. 2019 Oct 3;9(10):e031766. doi: 10.1136/bmjopen-2019-031766.
To assess the views of women after a first caesarean section (CS) on their birth experience, preference for future mode of birth and willingness to participate in a randomised controlled trial on mode of birth in a future pregnancy.
Questionnaire survey.
Two tertiary maternity centres Ireland, Galway University Hospital, Galwayand the National Maternity Hospital, Dublin.
Women with one previous CS.
Eligible women consented to participate, and postal surveys were forwarded. Results were collected and analysed. Results were compared between women who had elective operations and women who had emergency operations.
The satisfaction levels of women after a first caesarean, their preference for mode of birth in a future pregnancy and their willingness to participate in a randomised trial on mode of birth.
There were 347 completed surveys of 633 women who consented to participate (54.8%), of whom 285 and 62 had emergency and elective caesarean deliveries, respectively. In general, satisfaction ratings with the delivery were greater than 90%, with similar levels of satisfaction with the care received from doctors and midwives. Women who an emergency procedure expressed lower satisfaction levels with the information about the caesarean and the debriefing received afterwards than women who had a planned operation (p<0.05). For future mode of birth, 39.5% expressed a preference for vaginal birth after caesarean (VBAC) in a subsequent pregnancy, and 80% said they would consider involvement in a randomised trial in a future pregnancy.
Debriefing and counselling women after a CS is an important part of pregnancy care and can significantly impact on a woman's overall birth experience. A significant proportion of this cohort considered VBAC as a future birth option. These data indicate that a randomised trial on mode of birth after caesarean would be viewed positively by women in our population.
评估首次剖宫产术后女性对其分娩经历的看法、对未来分娩方式的偏好以及参与未来妊娠分娩方式随机对照试验的意愿。
问卷调查。
爱尔兰的两家三级妇产中心，戈尔韦大学医院（戈尔韦）和都柏林国家妇产医院。
有过一次剖宫产史的女性。
符合条件的女性同意参与，通过邮寄方式发放调查问卷。收集并分析结果。对接受择期手术的女性和接受急诊手术的女性的结果进行比较。
首次剖宫产后女性的满意度、对未来妊娠分娩方式的偏好以及参与分娩方式随机试验的意愿。
在633名同意参与的女性中，有347份调查问卷填写完整（54.8%），其中285名和62名分别接受了急诊剖宫产和择期剖宫产。总体而言，对分娩的满意度评分高于90%，对医生和助产士提供的护理满意度水平相似。接受急诊手术的女性对剖宫产相关信息及术后汇报的满意度低于接受择期手术的女性（p<0.05）。对于未来的分娩方式，39.5%的女性表示倾向于剖宫产后阴道分娩（VBAC），80%的女性表示会考虑参与未来妊娠的随机试验。
剖宫产术后为女性提供汇报和咨询是孕期护理的重要组成部分，会显著影响女性的整体分娩体验。这一队列中有很大一部分女性将VBAC视为未来的分娩选择。这些数据表明，我们人群中的女性会对剖宫产术后分娩方式的随机试验持积极态度。
