McClain C S
J Fam Pract. 1985 Sep;21(3):210-6.
Despite growing interest in vaginal birth after previous delivery by cesarean section, virtually no studies have examined patient decision making in any depth. This paper examines the social content and cognitive structure of pregnant women's decisions to attempt delivery by trial of labor or for elective repeat cesarean section. Three features of childbirth care strategies are discussed. First, social goals are as central to women's decisions as are medical risks. Second, women reinforce their decisions by defining multiple benefits for the preferred alternative and multiple hazards for the rejected alternative. Third, women do not attempt to assess the probabilities of particular outcomes, but instead construct mental images of anticipated events based upon past childbirth experience and expected consequences of the preferred course of action.
尽管先前剖宫产术后经阴道分娩越来越受到关注，但实际上几乎没有研究深入探讨患者的决策过程。本文研究了孕妇决定尝试经阴道分娩或选择性再次剖宫产的社会内容和认知结构。讨论了分娩护理策略的三个特点。第一，社会目标与医疗风险一样，对女性的决策至关重要。第二，女性通过为首选方案定义多种益处、为被否决方案定义多种风险来强化自己的决策。第三，女性并非试图评估特定结果的概率，而是根据过去的分娩经历和首选行动方案的预期后果构建预期事件的心理意象。
