患者带领的方法在剖腹产后进行阴道分娩
Nicholas Rubashkin1, Ifeyinwa Asiodu, Saraswathi Vedam
1Department of Obstetrics, Gynecology, & Reproductive Sciences, the Institute for Global Health Sciences, the Department of Family Health Care Nursing, School of Nursing, and the Department of Anthropology, History and Social Medicine, University of California, San Francisco, San Francisco, California; the Birth Place Lab and the School of Population & Public Health, University of British Columbia, Vancouver, British Columbia, Canada; and the Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
患者对剖腹产后阴道分娩 (VBAC) 概率得分的解释不同,往往挑战计算器对种族和民族的使用. 了解这些患者主导的方法可以改善咨询,以获得更公平的分娩体验.
科学领域:
- 生殖健康 生殖健康
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 健康差异 在健康上的差异
背景情况:
- 母胎医疗单位 (MFMU) 的VBAC计算器预测了剖腹产 (VBAC) 后阴道分娩的成功.
- 这个计算器将种族和种族作为风险因素,引发了对公平的担忧.
- 患者对导航这些预测的观点对于知情决策至关重要.
研究的目的:
- 描述患者如何解释VBAC概率得分.
- 探索患者使用VBAC计算器预测方法的方法,特别是关于种族和种族.
- 确定患者主导的策略,以了解剖腹产后的分娩结果.
主要方法:
- 定性研究涉及采访和记录的产前访问与各种患者之前的剖腹产分娩.
- 使用批判性和女权主义的方法来分析主题数据.
- 在MFMU VBAC计算器分数的背景下检查患者的决策.
主要成果:
- 31名参与者代表了不同的种族和民族背景.
- 预测的VBAC成功概率差异很大 (12%-95%).
- 确定了四个患者主导的解释主题:拒绝种族/种族,重新定义失败,考虑劳动经验和修改概率.
结论:
- 数字VBAC概率可能没有普遍的价值,特别是对于那些有强烈VBAC意图的人来说.
- 黑人和西班牙裔参与者挑战了计算器的种族/族裔风险因素,抵制了能力减少的影响.
- 患者主导的VBAC概率解释为以人为中心,公平的咨询提供了资源.
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