Perinatal factors related to negative or positive recall of birth experience in women 3 years postpartum in the Netherlands
Perinatal factors related to negative or positive recall of birth experience in women 3 years postpartum in the Netherlands
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DOI：
10.1111/j.1523-536x.2008.00223.x
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发表时间：
2008-06-01
影响因子：
2.5
通讯作者：
Buitendijk, Simone
中科院分区：
文献类型：
--
作者：
Rijnders, Marlies;Baston, Helen;Buitendijk, Simone
背景：到目前为止，几乎没有关于荷兰妇女产后情感幸福感和对所接受护理的满意度的研究。这项研究的目的是调查荷兰妇女在事件发生3年后对她们的生育经历的看法。方法：一份问卷邮寄给所有在2001年生过孩子，并且至少有一次产前、围产期或产后访问参与助产实践的妇女。2001年该指数出生后再次生育的女性并未被排除在外。我们特别要求受访者反思发生在2001年的出生。女性被要求说出她们现在回顾自己的分娩和分娩时的感受，有五个回答选项，从“非常高兴”到“非常不高兴”。结果：共收到产后问卷1309份，应答率为44%。与荷兰孕妇总人数相比，样本在分娩方式、出生地点和产科干预措施方面具有相当的代表性；然而，样本不能代表种族和最初的照顾者。分娩三年后，大多数女性对自己的分娩经历持积极态度，但超过16%的人对出生经历持负面态度。每5名初产妇中有1名以上对过去持负面看法，相比之下，每9名经产妇中只有1名。3年后进行负面回顾的调整优势比(OR)包括有阴道助产或计划外剖腹产(OR 2.6，95%CI 1.59-4.14)、没有在家分娩(OR 1.4，95%CI 1.04-1.93)、分娩期间转诊(OR 2.4，95%CI 1.48-3.77)、在止痛方面没有选择(OR 2.9，95%CI 1.91-4.45)、对疼痛处理不满意(OR 4.9，95%可信区间2.55~9.40)、对照顾者的负面描述(OR 2.9，95%可信区间1.85~4.40)、对婴儿或其自身生命的恐惧(OR 2.3，95%可信区间1.47~3.48)。结论：相当大比例的荷兰女性在产后3年消极地回顾了她们的生育经历。需要进行进一步的研究，以了解妇女在荷兰生育制度内的生育期望和经历，并审查旨在减少或修改与负面回忆有关的可控因素的产妇保健改革。
Background: Little research has been conducted to date on women's postnatal emotional well-being and satisfaction with the care received in the Netherlands. The aim of this study was to investigate Dutch women's views of their birth experience 3 years after the event. Methods: A questionnaire was mailed to all women who had given birth in 2001 and who had at least one prenatal, perinatal, or postnatal visit to the participating midwifery practice. Women who had a subsequent birth after the index birth in 2001 were not excluded. We specifically asked respondents to reflect on the birth that occurred in 2001. Women were asked to say how they felt now looking back on their labor and birth, with five response options from "very happy" to "very unhappy." Results: We received 1,309 postnatal questionnaires (response rate 44%). The sample was fairly representative with respect to the mode of delivery, place of birth, and obstetric interventions compared with the total Dutch population of pregnant women; however, the sample was not representative for ethnicity and initial caregiver. Three years after delivery, most women looked back positively on their birth experience, but more than 16 percent looked back negatively. More than 1 in 5 primiparas looked back negatively compared with 1 in 9 multiparas. Adjusted odds ratios (OR) for looking back negatively 3 years later included having had an assisted vaginal delivery or unplanned cesarean delivery (OR 2.6, 95% CI 1.59-4.14), no home birth (OR 1.4, 95% CI 1.04-1.93), referral during labor (OR 2.4, 95% CI 1.48-3.77), not having had a choice in pain relief (OR 2.9, 95% CI 1.91-4.45), not being satisfied in coping with pain (OR 4.9, 95% CI 2.55-9.40), a negative description of the caregivers (OR 2.9, 95% CI 1.85-4.40), or having had fear for the baby's life or her own life (OR 2.3, 95% CI 1.47-3.48). Conclusions: A substantial proportion of Dutch women looked back negatively on their birth experience 3 years postpartum. Further research needs to be undertaken to understand women's expectations and experiences of birth within the Dutch maternity system and an examination of maternity care changes designed to reduce or modify controllable factors that are associated with negative recall.