Mothers' attitudes about elective cesarean: results, expectations & satisfaction

母亲对选择性剖宫产的态度：结果、期望

• 批准号: 7844181
• 负责人: VICTORIA Lynn HANDA
• 金额: $ 1.06万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2009-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7844181
• 关键词: Address; Affect; Attitude; Baltimore; Birth; Caring; Childbirth; Client satisfaction; Country; Data; Goals; Growth; Health; Health Professional; Healthcare; Incidence; Institution; Investigation; Knowledge; Mothers; National Institute of Child Health and Human Development; Outcome; Physicians; Pregnancy; Process; Prospective Studies; Provider; Public Health; Quality of life; Recruitment Activity; Reporting; Research; Research Personnel; Role; Route; Science; Surveys; Teaching Hospitals; Time; Vaginal delivery procedure; Woman; Women' s Group; abstracting; comparison group; expectation; experience; patient expectation; patient oriented; population survey; preference; pressure; rapid growth; response; satisfaction; suburb; symposium

DESCRIPTION (provided by applicant): Summary/Abstract: Mothers' Attitudes about Elective Cesarean: Results, Expectations & Satisfaction The incidence of cesarean delivery is rising in the US, reaching 29% in 2004. An unknown proportion of US cesareans are "elective", defined as cesarean delivery in the absence of maternal or obstetrical indication. In 2003, it was estimated that 2- 3% of US births (more than 40,000 deliveries that year) were elective cesarean deliveries. That rate represented a 36% increase over two years. In response to this apparent rapid rise, the NICHD held a State-of-the-Science Conference in 2006 to address "Cesarean Delivery on Maternal Request (CDMR)". Presumably, consumer choice contributes to the rise in elective cesarean. However, a recent survey suggested that growth of elective cesarean may reflect physician, rather than maternal, preferences. In that survey, 9% of new mothers had "experienced pressure from a health professional" to undergo cesarean delivery but less than 1% had elected CDMR. Because of the low incidence of elective cesarean in the survey population, the researchers were unable to explore the attitudes and goals of women who elect cesarean birth. After reviewing these and other data, the NICHD State-of-the-Science Panel concluded that additional research is needed to address the limitations in our current knowledge about CDMR, patient satisfaction after CDMR, and quality-of-life outcomes after CDMR versus other modes of birth. In this proposed research, we will investigate whether the attitudes and expectations of women seeking elective cesarean differ from those of women planning vaginal birth. In addition, we will explore whether satisfaction with the birth experience differs between these two groups. We will recruit women planning elective cesarean and a comparison group of women planning vaginal birth. Using data collected from these two groups, we will address the following specific aims: (1) to investigate differences in birth-related goals between these two groups, (2) to investigate whether planned route of delivery influences satisfaction with the birth experience in these groups, and (3) to describe the decision process regarding mode of delivery. This will allow us to estimate the proportion of elective cesarean delivery that can be attributed to CDMR. Our long term objectives are to understand how maternal expectations and preferences affect decisions about childbirth. This research will be an important step to understanding the role of consumer choice in obstetrical practices. More information on patient expectations, satisfaction, and outcomes is critical to advancing our knowledge regarding the apparent rapid growth of elective cesarean delivery in the US. / Relevance: Mothers' Attitudes about Elective Cesarean: Results, Expectations & Satisfaction With over 4 million births in the US each year, the public health impact of elective cesarean delivery is potentially enormous. A 1% rise in elective cesarean would result in 40,000 additional cesarean births. This project will investigate how maternal expectations and preferences affect decisions about childbirth and will advance our knowledge regarding the apparent rapid growth of elective cesarean delivery in the US.

摘要/摘要：美国母亲对选择性剖宫产的态度：结果、期望与满意度剖宫产的发生率呈上升趋势，2004年达到29%。未知比例的美国剖宫产是“选择性的”，定义为在没有产妇或产科指征的情况下剖宫产。2003年，美国估计有2- 3%的新生儿（当年超过40,000例分娩）是选择性剖宫产。这一比例在两年内增长了36%。为应对这一明显的快速增长，联合国儿童与发展中心于2006年举行了一次科学状况会议，讨论“应产妇要求剖宫产”问题。据推测，消费者的选择促成了选择性剖宫产的增加。然而，最近的一项调查表明，选择性剖宫产的增长可能反映了医生的偏好，而不是母亲的偏好。在那次调查中，9%的新妈妈“在健康专家的压力下”接受了剖宫产，但只有不到1%的人选择了CDMR。由于调查人群中选择性剖宫产的发生率较低，研究人员无法探讨选择剖宫产的妇女的态度和目标。在回顾了这些数据和其他数据后，NICHD最新科学小组得出结论，需要进一步的研究来解决我们目前关于CDMR、CDMR后患者满意度以及CDMR后与其他分娩方式的生活质量结果的知识局限性。在这项拟议的研究中，我们将调查寻求选择性剖宫产的妇女的态度和期望是否与计划阴道分娩的妇女不同。此外，我们将探讨两组对分娩体验的满意度是否存在差异。我们将招募计划选择性剖宫产的妇女和计划阴道分娩的妇女作为对照组。使用从这两组收集的数据，我们将解决以下具体目的：(1)调查这两组之间分娩相关目标的差异，(2)调查计划的分娩路线是否影响这些组对分娩体验的满意度，以及(3)描述分娩方式的决策过程。这将使我们能够估计可归因于CDMR的选择性剖宫产的比例。我们的长期目标是了解母亲的期望和偏好如何影响分娩的决定。这项研究将是理解消费者选择在产科实践中的作用的重要一步。更多关于患者期望、满意度和结果的信息对于提高我们对美国选择性剖宫产明显快速增长的认识至关重要。/相关性：母亲对选择性剖宫产的态度：结果、期望和满意度美国每年有超过400万新生儿，选择性剖宫产对公共卫生的影响可能是巨大的。每增加1%的选择性剖宫产就会导致4万例额外的剖宫产。该项目将调查产妇的期望和偏好如何影响分娩的决定，并将提高我们对美国选择性剖宫产明显快速增长的认识。

项目成果

Maternal goals for childbirth associated with planned vaginal and planned cesarean birth.

与计划的阴道分娩和计划的剖腹产相关的母亲分娩目标。

• DOI: 10.1055/s-0031-1280598
• 发表时间: 2011
• 期刊: American journal of perinatology
• 影响因子: 2
• 作者: Quiroz,LieschenH;Blomquist,JoanL;Macmillan,Deborah;McCullough,Alexis;Handa,VictoriaL
• 通讯作者: Handa,VictoriaL