Maternal request for cesarean section due to fear of birth: Can it be changed through crisis-oriented counseling?
Maternal request for cesarean section due to fear of birth: Can it be changed through crisis-oriented counseling?
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DOI：
10.1111/j.1523-536x.2006.00107.x
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发表时间：
2006-09-01
影响因子：
2.5
通讯作者：
Oian, Pal
中科院分区：
文献类型：
--
作者：
Nerum, Hilde;Halvorsen, Lotta;Oian, Pal
工作背景：为了满足越来越多因害怕分娩而希望按计划进行剖腹产手术的孕妇的需要，成立了一个心理社会小组。本研究描述了干预，妇女的心理问题，在有关程度的恐惧，出生的方式和出生结果，妇女的满意度，他们的愿望的变化，他们对未来的生育的生育方式和生育的愿望。研究方法：研究样本包括86名孕妇与出生的恐惧和计划剖腹产的要求，谁是由心理咨询小组在北挪威大学医院在2000年至2002年期间。数据来自转诊信、产前和产时护理记录以及出生后2至4年的随访调查。结果：大多数妇女对分娩的恐惧伴随着广泛的心理社会问题。90%的人经历过焦虑或抑郁，43%的人有饮食失调，63%的人受到虐待。24%的精神病患者以前曾接受过治疗。干预后，86%的人改变了最初的剖宫产要求，准备阴道分娩。随访调查证实，长期满意改变他们的要求剖腹产。其中，69%的产妇是阴道分娩，31%的产妇是因产科指征而剖腹产。结论：临产激活了以前的创伤经历，虐待和精神障碍，可能会引起对阴道分娩的恐惧。当妇女因害怕分娩和要求剖腹产而被转介到专家服务时，她们开始意识到并在一定程度上克服了恐惧的原因，最喜欢阴道分娩。他们对后来的选择仍然很满意
Background: A psychosocial team was established to meet the needs of an increasing number of pregnant women referred for fear of birth who wished a planned cesarean. This study describes the intervention, the women's psychosocial problems in relation to degree of fear of birth, changes in their wishes for mode of birth and birth outcome, women's satisfaction with the intervention, and their wishes for future births. Methods: The study sample comprised 86 pregnant women with fear of birth and a request for planned cesarean, who were referred for counseling by a psychosocial team at the University Hospital of North Norway in the period 2000-2002. Data were gathered from referral letters, from antenatal and intrapartum care records, and from a follow-up survey conducted 2 to 4 years after the birth in question. Results: Fear of birth was accompanied by extensive psychosocial problems in most women. Ninety percent had experienced anxiety or depression, 43 percent had eating disturbances, and 63 percent had been subjected to abuse. Twenty-four percent of those with psychiatric conditions had previously been in treatment. After the intervention, 86 percent changed their original request for cesarean section and were prepared to give birth vaginally. The follow-up survey confirmed long-term satisfaction with having changed their request for a cesarean delivery. Of these, 69 percent gave birth vaginally and 31 percent were delivered by cesarean for obstetrical indications. Conclusions: Impending birth activates previous traumatic experiences, abuse, and psychiatric disorders that may give rise to fear of vaginal birth. When women were referred to a specialist service for fear of birth and request for cesarean, they became conscious of and to some degree worked through, the causes of their fear and most preferred vaginal birth. They remained pleased with their choice later