Study On The Health Management Of Pregnant Women Under The "Universal Two-child Policy"

Cesarean section is an effective way to deal with abnormal delivery and high-risk pregnancy,save the lives of pregnant women and perinatal children,and to a certain extent,reduce the maternal and perinatal mortality.In recent years,China has fully liberalized the "two child policy",which has increased the fertility rate of our population and brought new challenges to our country,which is already in a high cesarean section rate.The situation of maternal health management is relatively severe.Objective: This paper analyzes the changing trend of cesarean section rate and indication before and after the implementation of "two child policy".Based on the clinical data of a provincial women and children health hospital,this paper provides evidence-based basis for monitoring the safe in-hospital delivery data,summarizing the typical practices of hospital maternal management,promoting the medical quality of the hospital,and optimizing the policy of population eugenics.Methods: The clinical data of 34528 pregnant and lying in women before and after the implementation of the two-child policy(from January 2014 to December 2019)were collected and analyzed retrospectively.By using the questionnaire survey to understand the change of the cognition degree of the pregnant women to the delivery mode before and after the implementation of the policy,and analyze the influencing factors of the change of the cesarean section rate.Use a questionnaire survey to understand the changes in the degree of cognition of pregnant women before and after the implementation of the policy,and analyze the influencing factors that cause changes in cesarean section.Results: The number of 8381 cases before the implementation of the two child policy(January 1,2014-December 31,2015)increased to 13607 cases two years after the implementation of the policy(January 1,2016-December 31,2017),an increase of62.36%;and increased to 12530 cases four years after the implementation of the policy(January 1,2018-December 31,2019),an increase of 49.50%;the age of pregnant women before the implementation of the policy was 16-49 years old,the average age was29.27 years old,the age of pregnant women two years after the implementation of the policy was 16-50 years old,the average age was 29.96 years old,the average age increased by 0.69 years,the age of pregnant women four years after the implementation of the policy was 15-59 years old,the average age was 30.10 years old,the average age increased by 0.14 years.Before and after the implementation of the policy,the number of elderly women increased from 1185(14.14%)to 2458(18.06%)two years later and 2170cases(17.32%)four years later;and the number of women in labor increased from 2644(31.55%)to 4973(36.55%),4541(36.24%).Before the implementation of the policy,the number of cesarean section was 3979,accounting for 47.48%;two years after the implementation of the policy,the number of cesarean section was 5474,accounting for40.23%;four years after the implementation of the policy,the number of cesarean section was 5423,accounting for 43.28%;before the implementation of the policy,the number of spontaneous childbirth was 4402,accounting for 52.52%;two years after the implementation of the policy,the number of spontaneous childbirth was 8133,accounting for 59.77%;four years after the implementation of the policy,the number of spontaneous childbirth was 7107,accounting for 56.72%.The rate of cesarean section decreased by7.25%,four years after the implementation of the policy,the rate of cesarean section increased by 3.05% from the previous period.After the implementation of the two-child policy,the proportion of high-risk pregnant women increased,scarred uterus,serious complications and complications,placenta previa and the indication of previa indications increased significantly,and cesarean section indicated by social factors,fetal distress and huge children decreased significantly,P<0.05.The results of the questionnaire survey found that 51.14% of people chose to give birth in 2014,the top three reasons are that the babies born with strong resistance are smart and smart,which is conducive to postpartum recovery,and the cost of production is low;in 2016,61.93% of pregnant women choosing natural birth,the top three reasons are that the baby is resistant and smart,which is conducive to postpartum recovery and fewer postpartum complications;by 2019,57.95% of pregnant women have chosen natural birth,and the reasons are the top three It is conducive to postpartum recovery,less postpartum complications,and is conducive to breastfeeding.In 2014,48.86% of pregnant women tended to choose cesarean section,most of them believed that cesarean section had less pain,mature technology,relatively safe,and could not bear the risk of trial delivery failure;in 2016,38.07% of pregnant women chose cesarean section,most have comorbidities,have trial birth conditions,but cannot bear the risk of trial birth failure,or have indications for cesarean section;42.05%of pregnant women choose cesarean section in 2019 because of indications for cesarean section or pregnancy comorbidities.From 2014 to 2019,the benefits of maternal delivery,comorbidities and complications of pregnancy,precautions for cesarean section,the effect of cesarean section on the second pregnancy and delivery,and the best time to get pregnant after cesarean section,the rates are on the rise.Conclusion: We should increase the health education for women of childbearing age,publicize natural childbirth by means of propaganda videos,official account of We Chat,science folding,festival thematic activities,and actively carry out family members’ accompany,"Doula" delivery,painless childbirth and other humanized measures,which can effectively improve the awareness rate of pregnant and parturient women’s knowledge and reduce cesarean section of social factors.According to the indication of cesarean section and the changing trend of cesarean section rate,guide the departments to take effective measures,strengthen health education,actively promote labor analgesia,establish the incentive mechanism of natural delivery,and improve the ability of maternal treatment based on the indications of cesarean section and the trend of cesarean section.Government departments should use big data to establish a maternal health management database;build and improve the three-level maternal treatment network to fully guarantee maternal safety.