Two Hospitals In Beijing Maternal Cesarean Delivery Status And Influence Factors Of Research

Objective:This study is to describe the overall level of maternal cesarean section in Beijing and to explore the pregnant women’s awareness and the choice to cesarean section in different stages, and ultimately come to the conclusions that the influencing factors of increased cesarean section rate.Methods:This study will select two upper second-class hospitals in Beijing as the study site. The data collected every2days a week from June to December in2011, and randomly determine the2days a week. We invited all pregnant women to fill in the questionnaire themselves on the survey day. The first stage use quantitative research methods. The second stage use qualitative research methods——interview the doctors, nurses and pregnant women in this two hospitals. The third stage is a comprehensive analysis and multiple logistic regression analysis based on the first and the second stage’s results. Try to come to detailed description of the status of cesarean section in Beijing and to clarify the main influencing factors about the cesarean section.Result:①The maternal women’s average age is29years old, the youngest is19years old, the oldest is44, the women who are35years old and older than35accounted for8.04%. Most pregnant women are first pregnancy (81.9%). Almost half of the maternal women’education background are university (49.1%). More than half of the pregnant women’average household incomes are more than3000(60.3%). Most of the maternal employment is office workers (60.7%).②At the beginning of pregnancy,11.86%of pregnant women choose the cesarean section, mainly because the pain is minimal and the delivery time is short, the relevant factors also may be some knowledge on pregnant women with cesarean section and natural childbirth, these understandings are cesarean section is less pain, cesarean section is safer, natural childbirth is good to child’s development, natural childbirth recovery quicker, natural childbirth does not affect the body herself. Close to delivery,16.9%of pregnant women choose the cesarean section, the main reason is recommended by her doctor and her husband, the main reason of the doctor is based on the baby’s status and pregnant women themselves, the main reason of the husband is cesarean section is safer、the pain was minimal and not be so hard.259pregnant women choose the cesarean section,56.76%because of the baby that is not suitable for natural childbirth,32.43%is recommended by their doctors,27.41%because of their own health that is not suitable for natural childbirth,15.06%is delivery process has special circumstances.③The cesarean section rate of pregnant women in the two hospitals of this survey was48.8%(N=259). Among them, there are166cases that have clear clinical indications of cesarean section, accounting for64.09%of the total cesarean section, there are93cases that have no clear clinical indications of cesarean sect ion. If only pregnant women who have clinicalindi cations did cesarean section, then the survey cesarean section rate was31.26%, close to the normal level of cesarean section.④There are11independent variables included in the logistic regression analysis, only the recommendations about modes of delivery of the doctors, the pregnant women’s husbands, the pregnant women’s elders, and the pregnant women’s sisters, the four independent variables have impact on the pregnant women’s ultimate mode of delivery. Among them, the pregnant women’s doctors’recommendat ions have the mostimpact (OR=4.27), followed by the pregnant women’s husbands’(OR=1.72), the pregnant women’s sisters’(OR=1.56), the pregnant women’s elders’(OR=1.53).Conclusions:Influencing factors of the increasing rate of cesarean section, on the one hand, are the medical factors, including the improvement of the cesarean section surgical technique, cesarean section indications of man-made expand, on the other hand, are the social factors, including the recommendations from the people around pregnant women, the incorrect awareness of cesarean section, the impact of family planning policy, social customs, imperfect legal system building, professional ethics of medical staff. Such a high rate of cesarean section is due to social factors such as indications of unnecessary cesarean section.