Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK.
KU Leuven, Department of Development and Regeneration, Research Unit Women and Child, B-3000, Leuven, Belgium.
BMC Pregnancy Childbirth. 2021 Jul 2;21(1):475. doi: 10.1186/s12884-021-03898-z.
Pregnancy and childbirth are significant events in women's lives and most women have expectations or plans for how they hope their labour and birth will go. It is possible that strong expectations about labour and birth lead to dissatisfaction or other negative outcomes if these expectations are not met, but it is not clear if this is the case. The aim was therefore to synthesise prospective studies in order to understand whether unmet birth expectations are associated with adverse outcomes for women, their partners and their infants.
Searches were carried out in Academic Search Complete; CINAHL; Medline; PsycINFO, PsychArticles, PubMed, SCOPUS and Web of Science. Forward and backward searches were also completed. Studies were included if they reported prospective empirical research that examined the association between a mismatch in birth expectations/experience and postnatal outcomes in women, their children and/or their partners. Data were synthesised qualitatively using a narrative approach where study characteristics, context and methodological quality were extracted and summarised and then the differences and similarities among studies were used to draw conclusions.
Eleven quantitative studies were identified for inclusion from nine countries. A mismatch between birth expectations and experiences was associated with reduced birth satisfaction. Three studies found a link between a mismatch and the development of postnatal post-traumatic stress disorder (PTSD). The evidence was inconsistent for postnatal depression, and fear of childbirth. Only one study looked at physical outcomes in the form of health-related quality of life.
A mismatch between birth expectations and experiences is associated with birth satisfaction and it may increase the risk of developing postnatal PTSD. However, it is not clear whether a mismatch is associated with other postnatal mental health conditions. Further prospective research is needed to examine gaps in knowledge and provide standardised methods of measuring childbirth expectations-experiences mismatch. To ensure women's expectations are met, and therefore experience a satisfying birth experience, maternity providers should provide sensitive care, which acknowledges women's needs and preferences, is based on open and clear communication, is delivered as early in pregnancy as possible, and enables women to make their own decisions about care.
Protocol registration: PROSPERO CRD42020191081 .
怀孕和分娩是女性生活中的重大事件，大多数女性对自己的分娩过程都有期望或计划。如果这些期望无法实现，那么强烈的分娩期望可能会导致不满或其他负面结果，但目前尚不清楚是否存在这种情况。因此，本研究旨在综合前瞻性研究，以了解未满足的分娩期望是否与女性、其伴侣和婴儿的不良结局相关。
在 Academic Search Complete、CINAHL、Medline、PsycINFO、PsychArticles、PubMed、SCOPUS 和 Web of Science 中进行了检索。还进行了前向和后向搜索。如果研究报告了前瞻性实证研究，即检查分娩期望/经历与女性、其子女和/或伴侣产后结局之间的不匹配情况，则纳入研究。使用叙述性方法对数据进行综合分析，提取和总结研究特征、背景和方法学质量，然后利用研究之间的差异和相似性得出结论。
从九个国家确定了 11 项纳入的定量研究。分娩期望与经历不匹配与分娩满意度降低有关。三项研究发现，不匹配与产后创伤后应激障碍（PTSD）的发展有关。关于产后抑郁症和对分娩的恐惧，证据不一致。只有一项研究以健康相关生活质量的形式研究了身体结局。
分娩期望与经历不匹配与分娩满意度降低有关，并且可能增加产后 PTSD 的风险。但是，目前尚不清楚不匹配是否与其他产后心理健康状况有关。需要进一步进行前瞻性研究，以检查知识空白并提供衡量分娩期望-经历不匹配的标准化方法。为了确保满足女性的期望并因此获得满意的分娩体验，产妇提供者应提供敏感的护理，承认女性的需求和偏好，基于开放和明确的沟通，尽可能在妊娠早期提供，并使女性能够对护理做出自己的决定。
方案注册：PROSPERO CRD42020191081。
