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掌控局面:一项基于扎根理论的研究,探讨既往剖宫产术后女性协商水中分娩经历。

Taking the reins: A grounded theory study of women's experiences of negotiating water immersion for labour and birth after a previous caesarean section.

作者信息

Townsend B, Fenwick J, McInnes R, Sidebotham M

机构信息

School of Nursing and Midwifery, Griffith University, Australia.

Transforming Maternity Care Collaborative, Australia.

出版信息

Women Birth. 2023 Mar;36(2):e227-e236. doi: 10.1016/j.wombi.2022.07.171. Epub 2022 Aug 1.

Abstract

BACKGROUND

Women seeking a vaginal birth after a caesarean section (VBAC) frequently want to keep their subsequent labour and birth free from intervention. Water immersion (WI) during labour is potentially an effective tool for women having a VBAC for its natural pain-relieving properties. However, negotiating access to WI can be difficult, especially in the context of VBAC.

AIM

To explore women's experiences of negotiating WI for labour and birth in the context of VBAC.

METHODOLOGY

This Grounded Theory study followed Strauss and Corbin's framework and analytic process. Twenty-five women planning or using WI for their VBAC labour or birth were recruited from two midwifery practices and a social media group across Australia. Participants were interviewed during pregnancy and/or postnatally.

FINDINGS

'Taking the reins', the core category explaining the women's experiences of assuming authority over their birth, comprised five categories: 'Robbed of my previous birth experience'; 'My eyes were opened'; 'Water is my tool for a successful VBAC'; 'Actioning my choices and rights for WI', and 'Empowered to take back control'. 'Wanting natural and normal' was the driving force behind women's desire to birth vaginally. Two mediating factors: Having someone in your corner and Rules for birth facilitated or hindered their birth choices, respectively.

CONCLUSION

The women became active participants in their healthcare by seeking information and options to keep their birth experience natural and normal. Support from other women and advocacy in the form of continuity of midwifery care was crucial in successfully negotiating WI for their VBAC when navigating the complex health system.

摘要

背景

寻求剖宫产术后阴道分娩(VBAC)的女性通常希望后续的分娩过程不受干预。分娩期间的水浸(WI)因其天然的止痛特性,对进行VBAC的女性来说可能是一种有效的工具。然而,争取使用水浸分娩可能会很困难,尤其是在VBAC的情况下。

目的

探讨女性在VBAC背景下争取水浸分娩的经历。

方法

本扎根理论研究遵循施特劳斯和科尔宾的框架及分析过程。从澳大利亚的两家助产机构和一个社交媒体群组中招募了25名计划在VBAC分娩时使用或正在使用水浸分娩的女性。在孕期和/或产后对参与者进行了访谈。

结果

“掌控局面”这一核心类别解释了女性在分娩中掌握自主权的经历,它包含五个类别:“被剥夺了我之前的分娩经历”;“我眼界大开”;“水是我成功进行VBAC的工具”;“为水浸分娩采取我的选择和权利行动”,以及“有能力重新掌控局面”。“追求自然和正常”是女性希望阴道分娩的背后驱动力。两个调节因素:“有支持自己的人”和“分娩规则”分别促进或阻碍了她们的分娩选择。

结论

这些女性通过寻求信息和选择,以使她们的分娩经历自然和正常,从而成为自身医疗保健的积极参与者。在复杂的医疗系统中为VBAC成功争取水浸分娩时,来自其他女性的支持以及以连续助产护理形式进行的倡导至关重要。

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