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

描述(申请人提供)：摘要/摘要：母亲对选择性剖腹产的态度：结果、期望和满意度在美国，剖腹产率正在上升，2004年达到29%。未知比例的美国剖腹产是“选择性的”，定义为在没有产妇或产科指征的情况下进行剖腹产。2003年，据估计，2%-3%的美国新生儿(当年超过4万次分娩)是选择性剖腹产。这一比率在两年内增长了36%。为了应对这一明显的迅速增长，NICHD在2006年举行了一次科学状况会议，讨论“应产妇要求剖腹产”。据推测，消费者的选择导致了选择性剖腹产的增加。然而，最近的一项调查表明，选择性剖腹产的增长可能反映了医生的偏好，而不是产妇的偏好。在那次调查中，9%的新妈妈经历了来自健康专业人员的压力，要求进行剖腹产，但只有不到1%的人选择了CDMR。由于选择性剖腹产在调查人群中的发生率较低，研究人员无法探索选择剖腹产的女性的态度和目标。在审查了这些和其他数据后，NICHD科学状况小组得出结论，需要进行更多的研究来解决我们目前对CDMR的了解的局限性，CDMR后患者的满意度，以及CDMR与其他出生模式相比的生活质量结果。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，我们将探索这两组人对分娩体验的满意度是否存在差异。我们将招募计划择期剖宫产的妇女和计划阴道分娩的对照妇女。利用从这两个群体收集的数据，我们将解决以下具体目标：(1)调查这两个群体之间与出生相关的目标的差异，(2)调查计划中的分娩路线是否影响这些群体对分娩体验的满意度，以及(3)描述关于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关于分娩的决定。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增进我们对美国选择性剖腹产明显快速增长的了解至关重要。相关性：母亲对选择性剖腹产的态度：结果、期望和满意度美国每年超过400万名新生儿，选择性剖腹产对公众健康的影响潜在是巨大的。选择性剖腹产增加1%将导致额外的4万名剖腹产婴儿。这个项目将调查母亲的期望和偏好如何影响分娩的决定，并将促进我们对美国选择性剖腹产明显快速增长的了解。

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.