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孕妇在选择分娩方式时的自主权:范围综述。

Pregnant women autonomy when choosing their method of childbirth: Scoping review.

机构信息

Faculty of Medicine of the University of Porto, Porto, Portugal.

Obstetrics and Gynecology Unit - Mater Dei Health Network, Belo Horizonte, Brazil.

出版信息

PLoS One. 2024 Jul 11;19(7):e0304955. doi: 10.1371/journal.pone.0304955. eCollection 2024.

DOI:10.1371/journal.pone.0304955
PMID:38990936
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11238978/
Abstract

This paper has as its theme the autonomy of pregnant women in relation to choosing the method of birth for their child. The objective was to carry out a scoping review to study the literature and evidence of how autonomy is being offered to parturient women. Study design and location: In October 2023, a search was carried out using the terms "pregnant women" AND "delivery" AND "autonomy" in the following databases: PubMed, Web of Science, Scopus, Scielo and LILACS. The search included articles from 2016 to 2023. Of the 179 articles found, 15 met the criteria and were selected for this review. Results: the pregnant woman's autonomy in choosing the method of childbirth is influenced by several factors, such as the obstetrician's recommendation, the medical team, and negative and positive experiences. Thus, when this autonomy is shared with the obstetrician, the obstetrician recommends cesarean section as the safest route, but does not explain the benefits and harms of both routes (vaginal and cesarean section), causing the woman to accept the cesarean section. Midwives recommend vaginal birth because they believe it to be natural and safe and explain the benefits and harms of both methods, respecting the pregnant woman's choice of the method she prefers. Conclusion: women have the fundamental right to choose their method of birth and must be properly guided throughout prenatal care, whether by an obstetrician or a midwife, about the options, risks and benefits of each method of childbirth, respecting the ethical principle of beneficence.

摘要

这篇论文的主题是孕妇选择分娩方式的自主权。目的是进行范围综述,研究如何向产妇提供自主权的文献和证据。

研究设计和地点

2023 年 10 月,在以下数据库中使用“孕妇”和“分娩”和“自主权”这两个术语进行搜索:PubMed、Web of Science、Scopus、Scielo 和 LILACS。搜索包括 2016 年至 2023 年的文章。在 179 篇文章中,有 15 篇符合标准,被选入这篇综述。

结果

孕妇选择分娩方式的自主权受到多种因素的影响,如产科医生的建议、医疗团队、负面和正面的经验。因此,当这种自主权与产科医生分享时,产科医生建议剖腹产是最安全的途径,但没有解释两种途径(阴道和剖腹产)的利弊,导致妇女接受剖腹产。助产士推荐阴道分娩,因为他们认为这是自然和安全的,并解释两种方法的利弊,尊重孕妇选择她更喜欢的方法。

结论

妇女享有选择分娩方式的基本权利,必须在整个产前护理过程中得到适当指导,无论是由产科医生还是助产士,了解每种分娩方式的选择、风险和益处,尊重善行的伦理原则。

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本文引用的文献

1
Caesarean Section on Maternal Request-Ethical and Juridic Issues: A Narrative Review.产妇要求剖宫产术的伦理和法律问题:叙事性综述。
Medicina (Kaunas). 2022 Sep 10;58(9):1255. doi: 10.3390/medicina58091255.
2
A national survey of Australian midwives' birth choices and outcomes.澳大利亚全国助产士分娩选择和结局调查。
Women Birth. 2023 Mar;36(2):e246-e253. doi: 10.1016/j.wombi.2022.07.173. Epub 2022 Aug 1.
3
The Preferences of Modes of Child Delivery and Associated Factors Among Pregnant Women in Southern Ethiopia.埃塞俄比亚南部孕妇的分娩方式偏好及相关因素
Pragmat Obs Res. 2022 Jul 15;13:59-73. doi: 10.2147/POR.S370513. eCollection 2022.
4
Assessing Dutch women's experiences of labour and birth: adaptations and psychometric evaluations of the measures Mothers on Autonomy in Decision Making Scale, Mothers on Respect Index, and Childbirth Experience Questionnaire 2.0.评估荷兰女性的分娩经历:自主决策量表、尊重指数和生育体验问卷 2.0 的测量方法的调整和心理计量学评估。
BMC Pregnancy Childbirth. 2022 Feb 18;22(1):134. doi: 10.1186/s12884-022-04445-0.
5
The Impact of Culturally-Centered Care on Peripartum Experiences of Autonomy and Respect in Community Birth Centers: A Comparative Study.以文化为中心的护理对社区分娩中心围产期自主性和尊重体验的影响:一项比较研究。
Matern Child Health J. 2022 Apr;26(4):895-904. doi: 10.1007/s10995-021-03245-w. Epub 2021 Nov 24.
6
African American Women's Experiences with Birth After a Prior Cesarean Section.非裔美国妇女剖宫产后再次分娩的经历。
Matern Child Health J. 2022 Apr;26(4):806-813. doi: 10.1007/s10995-021-03277-2. Epub 2021 Nov 3.
7
The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.PRISMA 2020 声明:系统评价报告的更新指南。
BMJ. 2021 Mar 29;372:n71. doi: 10.1136/bmj.n71.
8
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9
Why women chose unassisted home birth in Malaysia: a qualitative study.为什么马来西亚的女性选择在家中无人协助的情况下分娩:一项定性研究。
BMC Pregnancy Childbirth. 2020 May 19;20(1):309. doi: 10.1186/s12884-020-02987-9.
10
Measuring respect and autonomy in Dutch maternity care: Applicability of two measures.测量荷兰产科护理中的尊重和自主权:两种测量方法的适用性。
Women Birth. 2020 Sep;33(5):e447-e454. doi: 10.1016/j.wombi.2019.10.008. Epub 2019 Nov 30.