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“这将决定我会生几个孩子”——既往剖宫产术后女性孕期的决策

'It will dictate how many children I will have"- Women's decision-making in pregnancy following a previous caesarean birth (CB).

作者信息

Monis Malitha, O'Connell Rhona, Andrews Tom

机构信息

Cork University Maternity Hospital, Cork, Ireland.

University College Cork, Ireland.

出版信息

Midwifery. 2023 Jan;116:103533. doi: 10.1016/j.midw.2022.103533. Epub 2022 Oct 30.

Abstract

UNLABELLED

Vaginal birth after caesarean (VBAC) is supported in systematic reviews (Wu et al., 2019) and national guidelines (RCOG, 2015) and women are expected to be involved in the decision-making process for either a repeat caesarean birth or planned VBAC.

AIM

To develop a Grounded Theory (GT) of women's decision making of their birth choices in pregnancy following a previous caesarean birth (CB) OBJECTIVE: To explore what determines women's birth choice and their decision making for birth following a previous CB.

DESIGN

Semi structured interviews with pregnant women were undertaken in order to develop a Glasserian Grounded Theory SETTING: Antenatal clinics and wards in a large tertiary level maternity hospital.

FINDINGS

The theory of 'Mentalizing Possibilities' is a substantive theory which explains pregnant women's decision making about their birth choices after a previous CB. Women's main concern is to achieve a positive experience. The core category of 'Mentalizing Possibilities' explains how women process their previous experience, adapt to uncertainty and deal with the decisional conflict. There are behavioural and cognitive strategies which women use to go through this process.

CONCLUSION

Women want a positive birth experience after a previous CB and require support and continuity in decision making to help them decide the optimal birth choice for their current pregnancy.

摘要

未标注

剖宫产术后阴道分娩(VBAC)在系统评价(Wu等人,2019年)和国家指南(英国皇家妇产科医师学院,2015年)中得到支持,并且期望女性参与再次剖宫产或计划VBAC的决策过程。

目的

构建一个关于曾有剖宫产史(CB)的孕妇做出分娩选择的扎根理论(GT)。

目标

探讨是什么决定了女性的分娩选择以及她们在既往剖宫产术后的分娩决策。

设计

对孕妇进行半结构化访谈,以构建格拉斯哥扎根理论。

地点

一家大型三级妇产医院的产前诊所和病房。

研究结果

“心理化可能性”理论是一个实质性理论,解释了曾有剖宫产史的孕妇对其分娩选择的决策过程。女性主要关注的是获得积极的体验。“心理化可能性”的核心类别解释了女性如何处理她们之前的经历、适应不确定性并应对决策冲突。女性在经历这个过程时会使用行为和认知策略。

结论

曾有剖宫产史的女性希望获得积极的分娩体验,并且在决策过程中需要支持和连贯性,以帮助她们为当前的妊娠决定最佳的分娩选择。

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