Fordham S
Br J Gen Pract. 1997 Feb;47(415):77-80.
The proportion of births taking place in the home of the mother has declined to less than 1% of the total, in spite of the lack of evidence of the benefits of hospitalization. Home confinement remains rare when supported by general practitioners; little is known of the preferences of women of childbearing age.
To examine the beliefs of women of childbearing age concerning the advantages and disadvantages of giving birth in hospital or their own homes, the choices of place of birth open to them, and the information required to enable an informed choice.
A self-administered postal questionnaire was sent to a sample of 340 women aged 20-40 years who were registered with the study practice--a single-handed urban general practice that supports home confinement.
Completed questionnaires were received from 68% (241) of subjects. Parity of respondents ranged from zero (24%) to five. Altogether, 76% (159) of the respondents had previously had children. A total of 97% (154) of the parous respondents had prior experience only of delivery in hospital. In all, 86% (198) of the respondents expressed a preference for hospital delivery for any future children, with 3.5% (8) preferring home and 10.5% (24) undecided. Preference for home birth was associated with multiparity and indecision with nulliparity (Kruskal-Wallis, P = 0.040). Most women believed that giving birth in hospital was safer than at home. Most women had little knowledge of the advantages and disadvantages of giving birth at home and in hospital, although there was substantial demand for further information, and a minority who were better informed than their peers. A minority of respondents spontaneously expressed hostility to all home confinements.
Women show a wide spectrum of opinion on this subject. Further information is needed for women to make a free and informed choice of place of birth; providing this in an acceptable form is likely to require knowledge of the individuals concerned.
尽管缺乏住院分娩有益的证据,但在家中分娩的比例已降至总分娩数的1%以下。在全科医生的支持下,在家中坐月子的情况仍然很少见;关于育龄妇女的偏好知之甚少。
研究育龄妇女对在医院或家中分娩的利弊的看法、她们可选择的分娩地点以及做出明智选择所需的信息。
向340名年龄在20至40岁之间、在该研究诊所登记的妇女发送了一份自行填写的邮政调查问卷,该诊所是一家支持在家中坐月子的城市单人全科诊所。
68%(241名)的受试者回复了完整的问卷。受访者的产次从零(24%)到五次不等。总计,76%(159名)的受访者此前生育过孩子。在所有经产妇受访者中,97%(154名)此前只有在医院分娩的经历。总体而言,86%(198名)的受访者表示未来生育时倾向于在医院分娩,3.5%(8名)倾向于在家中分娩,10.5%(24名)尚未决定。对在家分娩的偏好与多产相关,而未决定则与初产相关(Kruskal-Wallis检验,P = 0.040)。大多数妇女认为在医院分娩比在家中更安全。大多数妇女对在家中和医院分娩的利弊了解甚少,尽管她们对进一步信息有大量需求,并且有少数人比同龄人了解得更多。少数受访者自发表达了对所有在家中坐月子的敌意。
妇女在这个问题上表现出广泛的意见。需要向妇女提供更多信息,以便她们能够自由、明智地选择分娩地点;以可接受的形式提供这些信息可能需要了解相关个人的情况。