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哪些因素可以降低剖宫产率?——爱尔兰孕妇和临床医生的观点。

What would reduce caesarean section rates?-Views from pregnant women and clinicians in Ireland.

机构信息

School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland.

Health Information and Quality Authority, Dublin, Ireland.

出版信息

PLoS One. 2022 Apr 28;17(4):e0267465. doi: 10.1371/journal.pone.0267465. eCollection 2022.

Abstract

BACKGROUND

Caesarean section rates continue to rise in most parts of the world. While CS is a lifesaving procedure there is evidence that, beyond a certain threshold, CS rates may contribute to increased maternal and perinatal morbidity. This study aimed to elicit the views of pregnant women's and clinicians' on how CS rates might be reduced.

METHODS

Pregnant women and their partners, and clinicians working with pregnant women in a maternity hospital in the Republic of Ireland of Ireland, were invited to participate in focus groups. Eligibility criteria included all women attending antenatal classes and clinicians working with pregnant women. A convenience sample was used and interviews were audio recorded, transcribed, and analysed using thematic analysis.

RESULTS

Four focus group interviews were conducted with 30 clinicians and 15 pregnant women and two partners participated in three focus groups. A further two women were interviewed individually. Participants expressed a view that rising CS rates were impacted by a societal perception that CS had become a 'normal mode of birth'. Suggestions for reducing CS rates were offered by clinicians and pregnant women and their partners.

CONCLUSIONS

Clinicians and pregnant women consider that CS rates can be reduced if a shared philosophy supporting normal birth is prioritised alongside adequate resourcing. Women and their partners also believe that enhanced communication with clinicians is central to reducing CS rates.

摘要

背景

在世界上大多数地区,剖宫产率持续上升。虽然剖宫产是一种救命的手术,但有证据表明,超过一定的阈值,剖宫产率可能会导致产妇和围产期发病率增加。本研究旨在征求孕妇和临床医生的意见,了解如何降低剖宫产率。

方法

爱尔兰共和国一家妇产医院的孕妇及其伴侣和临床医生被邀请参加焦点小组。合格标准包括所有参加产前班的妇女和与孕妇一起工作的临床医生。采用便利抽样法,对访谈进行音频记录、转录和主题分析。

结果

共进行了 4 次焦点小组访谈,有 30 名临床医生和 15 名孕妇及其 2 名伴侣参加了 3 次焦点小组,另有 2 名妇女接受了单独访谈。参与者认为,社会上认为剖宫产已经成为“正常分娩方式”的观念,影响了剖宫产率的上升。临床医生和孕妇及其伴侣提出了降低剖宫产率的建议。

结论

临床医生和孕妇认为,如果优先考虑支持正常分娩的共同理念,并提供充足的资源,剖宫产率是可以降低的。妇女及其伴侣还认为,加强与临床医生的沟通是降低剖宫产率的关键。

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