School of Nursing, Midwifery and Paramedicine, Curtin University, Kent Street, Bentley WA 6102, Australia.
Women Birth. 2021 Sep;34(5):e442-e450. doi: 10.1016/j.wombi.2020.09.007. Epub 2020 Sep 28.
Women who have a caesarean birth can have an experience that may impact decision-making for subsequent births. For some women this decision-making can be associated with anxiety.
To provide rich, surface level descriptions by exploring women's experiences of their involvement in decision-making during a subsequent pregnancy after a previous caesarean birth.
A descriptive qualitative study was performed between May 2018 and February 2019 using Braun and Clarke's six steps guided analysis. Pregnant women with a previous caesarean birth, receiving antenatal care at a tertiary maternity hospital in Western Australia, and self-reported low to moderate levels of anxiety were invited to participate in a telephone interview.
Women's (n = 17) experiences revealed four themes: 1) Learning from past experiences (two sub-themes loss of control and coming to terms), 2) Claiming ownership in decisions (two sub-themes challenging professional judgement and prioritising her needs, wishes and preferences), 3) Being empowered (three sub-themes getting a full picture, speaking out, and not just the baby or a number), 4) Moving forward (two sub-themes building trust in health professionals and establishing guardrails to minimise loss of control).
Women's experiences around decision-making in a subsequent pregnancy can vary according to whether their fears and anxieties are acknowledged and addressed. Women who are informed, and receive support and respect are empowered to move forward.
Continuity of care may provide women with more opportunities to build trusting relationships with clinicians and be truly known as an individual with unique preferences and desires.
经历剖宫产分娩的女性可能会对后续分娩的决策产生影响。对于某些女性来说,这种决策可能会与焦虑有关。
通过探索女性在先前剖宫产分娩后的后续妊娠中参与决策的经历,提供丰富的、表面层次的描述。
本研究于 2018 年 5 月至 2019 年 2 月采用 Braun 和 Clarke 的六步引导分析法进行了描述性定性研究。邀请在西澳大利亚州一家三级妇产医院接受产前护理且自我报告焦虑程度为低至中度的先前有剖宫产分娩史的孕妇参加电话访谈。
女性(n=17)的经历揭示了四个主题:1)从过去的经验中学习(两个子主题:失去控制和接受现实);2)对决策拥有自主权(两个子主题:挑战专业判断和优先考虑她的需求、愿望和偏好);3)被赋权(三个子主题:全面了解情况、大胆表达意见、不只是婴儿或数字);4)向前迈进(两个子主题:建立对卫生专业人员的信任和建立护栏以尽量减少失去控制)。
女性在后续妊娠中的决策经历可能因她们的恐惧和焦虑是否得到承认和解决而有所不同。女性如果获得信息、得到支持和尊重,就会被赋予权力向前迈进。
连续护理可能为女性提供更多机会与临床医生建立信任关系,并真正了解她们作为一个具有独特偏好和愿望的个体。