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

描述（由申请人提供）：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，剖腹产的发生率正在上升，2004年达到29%。美国剖腹产的比例未知是“选择性的”，定义为在没有母体或产科指征的情况下进行剖腹产。2003年，据估计，2- 3%的美国出生（当年超过40，000例分娩）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快速增长，2006年，NICHD举行了一次科学现状会议，讨论“应产妇要求剖腹产"问题。据推测，消费者的选择有助于增加选择性剖宫产。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，而不是母亲的偏好。在该调查中，9%的新妈妈“经历了来自健康专业人士的压力”，接受了剖腹产，但只有不到1%的人选择了CDMR。由于在调查人群中选择性剖宫产的发生率很低，研究人员无法探讨选择剖宫产的妇女的态度和目标。在审查了这些数据和其他数据后，NICHD科学现状小组得出结论，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后的患者满意度，以及CDMR后与其他分娩方式相比的生活质量结果。在这项拟议的研究中，我们将调查妇女寻求择期剖宫产的态度和期望是否与计划阴道分娩的妇女不同。此外，我们将探讨这两组之间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。使用从这两组中收集的数据，我们将解决以下具体目标：（1）调查这两组之间与出生相关的目标的差异，（2）调查计划的分娩路线是否影响这些组中对分娩体验的满意度，以及（3）描述有关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产妇的期望和偏好如何影响分娩的决定。这项研究将是一个重要的一步，了解消费者的选择在产科实践中的作用。关于患者期望、满意度和结局的更多信息对于推进我们关于美国择期剖宫产明显快速增长的知识至关重要。/相关性：母亲对选择性剖腹产的态度：结果，期望和满意度在美国每年有超过400万的新生儿，选择性剖腹产对公共卫生的影响是巨大的。选择性剖腹产增加1%将导致40，000例额外的剖腹产。本项目将调查产妇的期望和偏好如何影响分娩的决定，并将推进我们对美国择期剖宫产明显快速增长的认识。

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.