باور زنان با سابقه سزارین قبلی در زمینه زایمان طبیعی پس از سزارین: مطالعه کیفی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه مامایی، مرکز تحقیقات بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

2 دانشیار گروه مامایی، مرکز تحقیقات بیماریهای مادر و جنین، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

چکیده

مقدمه: زایمان طبیعی برای اکثر زنانی که سزارین قبلی با برش عرضی داشته­اند، یک روش زایمانی ایمن محسوب می­شود. با این حال اکثر زنان که سزارین قبلی داشته­اند، به‌ندرت زایمان طبیعی را انتخاب می­کنند. مطالعه حاضر با هدف تبیین باور زنان با سابقه سزارین قبلی در زمینه زایمان طبیعی پس از سزارین، به‌منظور ارائه برخی پیشنهادات در مورد مداخلات آتی جهت افزایش زایمان طبیعی انجام شد.
روش‌کار: این مطالعه کیفی با چارچوب تئوری رفتار برنامه­ریزی­شده از فروردین تا اسفند ماه 1397 در بیمارستان‌های دولتی ارومیه انجام یافت. داده­ها با انجام 24 مصاحبه نیمه­ساختار­یافته عمیق انفرادی جمع­آوری شد. مشارکت‌کنندگان از طریق نمونه­­گیری مبتنی ­بر هدف تا رسیدن به اشباع اطلاعات از بین زنان باردار و زایمان کرده با سابقه سزارین انتخاب شدند. تجزیه و تحلیل داده­ها به­روش تحلیل محتوای کیفی از نوع هدایت ­شده با نرم‌افزار MAXqda (نسخه 10) انجام شد.
یافته­ها: از تحلیل داده­ها، سه درون­مایه "نگرش نسبت به زایمان طبیعی پس از سزارین" (زایمان طبیعی روشی سریع و مقرون به­صرفه، احساس خطر از آسیب مادری- جنینی)، "باورهای هنجاری نسبت به زایمان طبیعی پس از سزارین" (تأکید افراد مهم برای انجام زایمان طبیعی پس از سزارین، برداشت زنان در مورد زایمان طبیعی پس از سزارین در اجتماع) و "باورهای کنترلی نسبت به زایمان طبیعی پس از سزارین" (موانع و تسهیل­کننده­های فردی و اجتماعی) حاصل شد.
نتیجه­گیری: نگرش، هنجارهای انتزاعی و باورهای کنترلی زنان در انتخاب زایمان طبیعی پس از سزارین تأثیر دارد.  آموزش‌های مبتنی بر تئوری رفتار برنامه‌ریزی شده می‌تواند با هدف گسترش زایمان طبیعی پس از سزارین مورد توجه قرار ­گیرد.

کلیدواژه‌ها


عنوان مقاله [English]

Beliefs of women with a history of Previous Cesarean Section regarding Vaginal Birth after Cesarean: A qualitative study

نویسندگان [English]

  • Roghieh Bayrami 1
  • Roksana Janghorban 2
1 Assistant professor, Department of Midwifery, Reproductive Health Research Center, School of Nursing and Midwifery, Urmia Universityof Medical Sciences, Urmia, Iran.
2 Associate professor, Department of Midwifery, Maternal-Fetal medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
چکیده [English]

Introduction:Vaginal birth is considered a safe mode of birth for most women who have had a prior caesarean with a transverse incision. However, most women who had a previous caesarean rarely choose vaginal delivery. The present study was performed with aim to explain the beliefs of women with a history of previous cesarean section regarding vaginal birth after cesarean in order to provide some suggestions for future interventions to increase vaginal delivery.
Methods: This qualitative study framed by the Theory of Planned Behavior was conducted in the governmental hospitals of Urmia, Iran in March-February 2017. Data were collected using 24  in-depth semi-structured individual interviews.  Participants were selected among  pregnant and postpartum women with a history of cesarean section through purposeful sampling, until data saturation was reached. Data were analyzed through directed content analysis approach using the MAXqda software (version 10).
Results: The findings were grouped into three themes namely: "attitude towards vaginal birth after cesarean" (Vaginal birth as a fast and cost-effective method of delivery, sense of danger about maternal-fetal harm), "normative beliefs towards vaginal birth after cesarean" (the emphasize of important people towards vaginal birth after cesarean, women's impression of vaginal birth after cesarean in the community) and "control beliefs towards vaginal birth after cesarean" (Individual and social barriers and facilitator).
Conclusion: Women's attitudes, subjective norms, and control beliefs influence choosing vaginal childbirth after cesarean section. Education based on the theory of planned behavior could be considered with the aim of promoting vaginal delivery after cesarean section.

کلیدواژه‌ها [English]

  • Behavior
  • Psychological theory
  • Qualitative research
  • Vaginal Birth after Cesarean
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