Department of Obstetrics and Gynecology, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
School of Health Professions, Bern University of Applied Sciences, 3008, Bern, Switzerland.
Arch Gynecol Obstet. 2023 May;307(5):1481-1488. doi: 10.1007/s00404-023-06913-0. Epub 2023 Jan 16.
In Switzerland, about one in three children is born by caesarean section (CS). For many women, this means a restricted birth experience, limited observation of the birth process and a restricted involvement. We evaluated an extended gentle CS protocol, which offered early intraoperative skin-to-skin contact and the possibility of observing the delivery of the baby from the abdomen through a transparent drape.
This is a cross-sectional study incorporating data from a purposely tailored questionnaire and clinical routine data. The extended gentle CS protocol was compared with the gentle CS, which does not allow the possibility of observing the delivery. Data were collected online and analysed by multivariable regression for quantitative data and content analysis for all text responses to open questions, respectively.
193 women completed the questionnaire. Of these, 154 had a gentle CS and 39 had an extended gentle CS. Multivariable regression did not reveal a statistically significant difference for extended gentle CS with regard to satisfaction with childbirth, mother-to-child bonding, or breastfeeding duration. Nevertheless, early intraoperative skin-to-skin contact was associated with the fulfilment of birth expectations. Furthermore, most women who experienced an extended gentle CS would prefer the same procedure for any potential future CS.
Although our study showed no statistically significant difference in satisfaction from using a transparent drape, most women expressed a preference for this technique. We recommend that the option of an extended gentle CS should be offered to all women for whom CS is indicated.
在瑞士,大约每三个孩子中就有一个通过剖腹产(CS)出生。对于许多女性来说,这意味着分娩体验受限,无法观察分娩过程,参与度也受到限制。我们评估了一种扩展的温和 CS 方案,该方案提供了术中早期的皮肤接触,并通过透明帘幕观察腹部娩出婴儿的过程。
这是一项横断面研究,纳入了专门设计的问卷调查和临床常规数据。将扩展的温和 CS 方案与不允许观察分娩过程的温和 CS 方案进行比较。数据通过在线收集,并分别通过多变量回归分析定量数据和内容分析所有文本回答的开放性问题进行分析。
193 名女性完成了问卷调查。其中,154 名女性接受了温和 CS,39 名女性接受了扩展的温和 CS。多变量回归分析显示,在分娩满意度、母婴联系或母乳喂养持续时间方面,扩展的温和 CS 没有统计学上的显著差异。然而,术中早期的皮肤接触与实现分娩期望有关。此外,大多数经历过扩展温和 CS 的女性表示,她们希望在任何潜在的未来 CS 中都采用相同的程序。
尽管我们的研究显示使用透明帘幕在满意度方面没有统计学上的显著差异,但大多数女性表示更喜欢这种技术。我们建议,对于所有需要 CS 的女性,应提供扩展的温和 CS 选择。