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剖宫产后再次分娩方式的选择:波兰基于网络的横断面调查

Women's views and preferences regarding the mode of birth after cesarean section: Polish cross-sectional web-based survey.

机构信息

Department of Reproductive Health, Centre of Postgraduate Medical Education, Żelazna 90, 01-004 Warsaw, Poland.

Department of Midwifery, Centre of Postgraduate Medical Education, Żelazna 90, 01-004 Warsaw, Poland.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2022 Jun;273:26-32. doi: 10.1016/j.ejogrb.2022.04.006. Epub 2022 Apr 15.

DOI:10.1016/j.ejogrb.2022.04.006
PMID:35453069
Abstract

OBJECTIVE

Currently, the most common indication for cesarean section is a previous cesarean section. Some of them are performed for no medical reasons. Therefore, it is crucial to recognize the preferences and expectations of women concerning birth after cesarean section. This study's main aim was to understand the women's points of view on the mode of birth after cesarean.

STUDY DESIGN

A cross-sectional study was conducted, and data was collected using an original structured online questionnaire. The study group consisted of 733 pregnant Polish women who had previously undergone a cesarean birth.

RESULTS

Women more often preferred vaginal birth after cesarean section (73.26%) and less frequently (23.33%) chose elective cesarean section. Women preferring VBAC when making decisions were guided by the benefits, opportunities, and risks associated with each mode of birth. For women preferring elective cesarean section the only highly significant factor was the experience of previous deliveries. Women mainly use Internet sources and the support of other women giving birth after cesarean section. More than half of the women did not talk about the mode of birth with their midwife, and every fifth did not talk about it with the obstetrician.

CONCLUSION

Obstetric history and personal beliefs about birth after cesarean section, motivations, and concerns about childbirth affect women's preferences regarding the mode of birth. It is necessary to educate women, in particular, talks about the opportunities and risks associated with cesarean birth carried out by the medical staff at an early stage of pregnancy.

摘要

目的

目前,剖宫产最常见的指征是既往剖宫产。其中一些手术并非基于医学原因。因此,了解女性对剖宫产后分娩方式的偏好和期望至关重要。本研究的主要目的是了解女性对剖宫产后分娩方式的观点。

研究设计

这是一项横断面研究,通过原创的结构化在线问卷收集数据。研究组由 733 名曾行剖宫产的波兰孕妇组成。

结果

女性更倾向于剖宫产后阴道分娩(73.26%),而选择择期剖宫产的频率较低(23.33%)。在做出决策时,选择 VBAC 的女性会考虑每种分娩方式的益处、机会和风险。对于选择择期剖宫产的女性,唯一高度显著的因素是既往分娩经历。女性主要通过互联网资源和其他剖宫产后分娩的女性的支持来获取信息。超过一半的女性没有与助产士讨论分娩方式,每五分之一的女性没有与产科医生讨论。

结论

产科史和个人对剖宫产后分娩的信念、动机以及对分娩的担忧影响着女性对分娩方式的偏好。有必要对女性进行教育,特别是在妊娠早期由医护人员就剖宫产相关的机会和风险进行讨论。

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