Scholten Nadine, Strizek Brigitte, Okumu Mi-Ran, Demirer Ibrahim, Kössendrup Jan, Haid-Schmallenberg Lissa, Bäckmann Malte, Stöcker Arno, Stevens Natalie, Volkert Anna
Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University Hospital Bonn, Venusberg-Campus 1, Gebäude 02, Auenbruggerhaus, 53127, Bonn, Germany.
Chair for Health Services Research, Faculty of Human Sciences and Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Eupener Str. 129, 50933, Cologne, Germany.
Arch Gynecol Obstet. 2025 Mar;311(3):591-598. doi: 10.1007/s00404-024-07770-1. Epub 2024 Nov 4.
Considering the inconclusive evidence regarding the clinical benefits of specific birthing positions, emphasis has been placed on adhering to women's preferences during the second stage of labour. Therefore, the present study aimed to assess the association between birthing position, the freedom to choose a birth position during the second stage of labour, and women's subjective satisfaction with childbirth.
We performed a cross-sectional survey of women 8 or 12 months after a vaginal birth in a hospital. The women were recruited via two cooperating health insurance companies. Multivariate analyses were conducted to assess the strength of the association between birthing position and maternal satisfaction with childbirth, with a particular focus on interactions with self-determination.
In total, the data from 761 women were analysed. The supine position was the most frequently reported birthing position in the second stage of labour at 77.5%. Notably, 39.0% and 30.5% of the women who gave birth in the dorsal and lateral supine positions, respectively, stated that the birth position was not chosen voluntarily. The regression models show a significant negative association between supine birthing position and satisfaction with childbirth, which is significantly related to self-determination. The most common reason for the adoption of a specific birthing position was instructions from medical staff.
The data provide insight into the perceived satisfaction with childbirth depending on the birthing position, whereby the relevance of self-determination is particularly evident. At the same time, self-determination is often not given, which is associated with reduced birth satisfaction.
鉴于关于特定分娩姿势临床益处的证据尚无定论，人们已将重点放在分娩第二阶段尊重女性的偏好上。因此，本研究旨在评估分娩姿势、分娩第二阶段选择分娩姿势的自由度与女性对分娩的主观满意度之间的关联。
我们对一家医院阴道分娩8或12个月后的女性进行了横断面调查。这些女性是通过两家合作的健康保险公司招募的。进行多变量分析以评估分娩姿势与产妇分娩满意度之间关联的强度，特别关注与自主决定权的相互作用。
总共分析了761名女性的数据。仰卧位是分娩第二阶段最常报告的分娩姿势，占77.5%。值得注意的是，分别在仰卧位和侧卧位分娩的女性中，有39.0%和30.5%表示分娩姿势不是自愿选择的。回归模型显示仰卧位分娩姿势与分娩满意度之间存在显著负相关，这与自主决定权显著相关。采用特定分娩姿势的最常见原因是医护人员的指示。
这些数据提供了根据分娩姿势对分娩满意度的洞察，其中自主决定权的相关性尤为明显。与此同时，自主决定权往往得不到保障，这与分娩满意度降低有关。
