The Effect of Family Members' Participation during Labor and Delivery on Women's Reproductive Health/Rights -The Relationship between Objective and Subjective Stress on Parturient Women and Their Fetuses

日本产妇分娩时有无家属陪伴对围产儿结局的影响本研究对1011例经阴道分娩的已婚产妇进行了研究。他们的家人(n=609)自愿在分娩和分娩时在场，其余的家人(n=402)拒绝在场。体格数据取自受试者的临床病历。初产妇和经产妇90%的接生员为丈夫，初产妇为15.8%的产妇，经产妇为42.3%的子女。虽然“家庭在场”分娩的妊娠期和临产障碍发生率显著高于“家庭在场”分娩，但产妇治疗率却显著低于“家庭缺席”分娩。这些结果表明，“家庭在场”分娩是可以保证严格执行产妇治疗的。因此，推广以家庭为中心的围产期护理是非常重要的。…与OBJE的相关性产程中家属参与分娩的主动性和主观性增加我们测定了10 7例足月妊娠孕妇的母体静脉血、脐静脉血皮质醇和β-内啡肽水平。血清皮质醇和β-内啡肽浓度在分娩和分娩期间显著升高，但在分娩后3天恢复到妊娠36-40周的浓度。STAI与分娩疼痛、皮质醇水平呈显著正相关。有家庭成员陪伴分娩的初产妇皮质醇浓度高于有家庭成员陪伴的初产妇。尤其是对于初产妇来说，这一趋势尤为显著。此外，在分娩过程中没有家人在场的妇女比其他情况下有更强的疲惫、焦虑和分娩疼痛。从这些结果可以得出结论，没有家庭成员参与的初产妇在分娩过程中承受着很大的压力。因此，重要的是促进家庭成员在初产妇分娩和分娩期间的参与。较少

Comparison of Perinatal Outcomes between with and without Family Members' Presence during Delivery in Japanese WomenMarried parturients (n=1011) with vaginal birth were subjected to this study. Their family members (n=609) volunteered to be present during labor and delivery, while the rest family members (n=402) declined to be present. Physical data were obtained from subjects' clinical charts. Ninety percent of birth attendants were their husbands for primiparas and multiparas, and 15.8% of their mothers for primiparas, 42.3% of their children for multiparas. Though the rates of pregnant and parturient disorders in the ‘family present' delivery were significantly higher, the rate of parturient treatment was significantly lower than those in the ‘family absent' delivery. These results show that ‘family present' delivery can be guaranteed strict execution of parturient treatments. Therefore, it is important to promote family- centered care for perinatal period.The Relevance between Obje … More ctive and Subjective Stress in the Family Members' Participation during Labor and DeliveryWe measured maternal venous, umbilical venous cortisol and β-endorphin levels of 107 pregnancies at term. Serum cortisol and β-endorphin concentrations rose significantly during labor and delivery but returned to the concentrations of 36-40 wks of gestation by 3 days after delivery. There were significant positive correlations between STAI, labor pain and cortisol levels. In primiparas with family members' absence during birth, cortisol concentrations were higher than those with family members' presence. Especially this tendency was remarkable for the primiparas. Besides, women without family members' presence during delivery had stronger fatigue, anxiety and labor pain than in other cases. From these results, it may be concluded that the primiparas without family members' participation are under much stress during labor and delivery. Therefore, it is important to promote family members' participation during labor and delivery for primiparas. Less