Quantitative And Qualitative Study On The Childbirth Experience Of Puerperant With Accompanying Delivery During Cesarean Section Surgery

Part 1 Quantitative studyObjective This study analyzed the relationship between the changes of basic,neonatal,maternal delivery and psychological status and the mode of accompanying delivery during cesarean section surgery,investigating and exploring the factors of delivery experience,the correlation between accompany delivery and childbirth experience by qualitative study for improving childbirth experience and delivery outcome.Methods All patients undergoing elective cesarean section combined spinal epidural anesthesia were selected and they must accord with the international guidelines for cesarean section,aged 20-40 years and ASA gradesⅠtoⅡ.They were divided into 2groups by maternal participation:non-accompanying delivery group（group A,n=100）and accompanying delivery group（group B,n=80）.Group A took conventional method to anesthetize and operate,then all infants leaving the operating room within midwife’s embrace.According to the requirements of prevention and control of hospital infection in operating room,after Group B spinal anesthesia and sterilizing,member of patient was informed by anesthesiologist in designated operating room.These member should encourage and comfort patients’anxiety,then all infants leaving the operating room within member’s embrace.We collected all of maternal general conditions,demographic data,obstetric and neonatal data in Group A and B before operation,recording the Apgar scores at 1 min（T₀）,5 min（T₁）and 10 min（T₂）after birth to evaluate the condition in newborn,the CEQ2.0 to evaluate their childbirth experience,the SDS and SAS of patients to evaluate depression and anxiety of antenatal（D₀）,after 3 days（D₁）and after 1 week（D₂）,the distribution of family members.The data were processed by SPSS20.0,using T test and chi square（χ²）test to analyze results.Results（1）There were no significant differences in general information between two groups.（2）There were no remarkable differences in the Apgar scores at T₀,T₁ and T₂after birth within and between two groups.（3）Compared with the total score of childbirth experience,self-ability,professional support,security perception and participation,group B was significantly higher than group A（P<0.05）.（4）There were no significant differences between two groups during operation.（5）Compared D₁ between two groups,group B was significantly lower than group A（P<0.05）.While there were no significant differences in D₀ and D₂ of SAS between two groups.（6）There were no significant differences in D₁,D₀ and D₂ of SDS between two groups.（7）Analyzing the distribution of family members,spouse was the most important choice（96.25%）,followed by sisters（2.5%）and wives of brothers（1.25%）.Conclusion（1）The mode can effectively improve maternal childbirth experience during cesarean section surgery.（2）The mode of accompanying delivery during cesarean section surgery can obviously better early postoperative anxiety（PPA）,however,it has no obvious effect on postoperative depression（PPD）and long-term PPA.（3）Accompanying delivery during cesarean section surgery has no obvious effect on neonatal condition in Apgar.Part 2 Qualitive studyObjective This study investigated and explored the factors of delivery experience,the correlation between accompany delivery and childbirth experience by qualitative study to provide reference for optimizing perinatal intervention.Methods All patients undergoing elective cesarean section combined the mode of accompanying delivery.Patients and their family were classified by age,education level,economic status and occupation before operation.The phenomenology and semi-structured interview was used to in 13 patients.After interview we sorted out the data in time and use NVivo 11.0 combined with colaizzi phenomenological analysis method to analyze the statistics,refine relevant subject content and summarize results.Results Through collecting and refining,5 related themes were summarized:Primiparas have psychological burdens during cesarean section;the positive effect of accompanied childbirth by their family;There are advantages in accompanying delivery;Identifying the source of family accompany;There are a few deficiencies in the mode of accompany.Conclusion For the pregnant women participating in cesarean section,accompanying delivery provide good support for patients,promote doctor-patient relationship,family relationship and psychological response ability,eventually reducing perinatal psychological disorders.It also can effectively relieve the psychological pressure and promote childbirth experience of patients.