Trowell J A
Child Abuse Negl. 1983;7(4):387-94. doi: 10.1016/0145-2134(83)90045-5.
This study follows a group of women who had their first babies by emergency caesarian section under a general anaesthetic and compares them with a control group who had a normal vaginal delivery. The emergency caesarian sections were not done for a clear cut medical emergency but for reasons such as foetal distress, prolonged labour, suspected cephalopelvic disproportion--all criteria open to different clinical judgment. The mothers and babies were seen one month, one year and three years after delivery. Significant differences were found between the attitude and behaviour of the caesarian group of mothers and that of the control group of mothers. There must be serious doubts about the need for an emergency caesarian delivery in this sample. They were a problem group of women as difficult to follow up as to deliver. In their histories there was a trend toward more difficulties in their past and present relationships. Did they need more sensitive handling during delivery to avoid an emergency caesarian section? Professionals frequently find anxiety hard to bear and need to act rather than attempt to understand the origin of the pain. It is easy to overlook the subtle long term effects of the action when it appears to solve the immediate problem.
本研究跟踪了一组在全身麻醉下接受首次紧急剖宫产的女性,并将她们与正常阴道分娩的对照组进行比较。这些紧急剖宫产并非因明确的医疗急症而进行,而是由于胎儿窘迫、产程延长、疑似头盆不称等原因——所有这些标准都存在不同的临床判断。在分娩后1个月、1年和3年对母亲和婴儿进行了观察。剖宫产组母亲和对照组母亲的态度及行为之间存在显著差异。对于该样本中紧急剖宫产的必要性,必然存在严重疑问。她们是一群问题女性,随访和分娩一样困难。在她们的病史中,过去和现在的人际关系中存在更多困难的趋势。她们在分娩期间是否需要更敏感的处理以避免紧急剖宫产?专业人员常常觉得焦虑难以承受,需要采取行动而非试图理解疼痛的根源。当行动似乎解决了眼前问题时,很容易忽视其细微的长期影响。