| ObjectivesThe article was to understand the current situation and the influencing factors ofthe puerperae’ cesarean delivery in Hengyang, to illuminate the contribution ofimplementing cesarean to high cesarean rate under the non-medical condition, andanalyze the reasons of the high rate; To probe the influences of the intervention ofnursing health education to the willingness of the pregnant choosing the deliverymodes, and to evaluate the effect of reducing cesarean under the nursing healtheducation intervention during the pregnancy.MethodsUsing stratified cluster sampling method, randomly extracting four hospitals,including the tertiary hospital, secondary hospitals, private women’s and children’shospital and district maternal and child hospital, In July2013-August2013weinvestigate1000Hospital childbirth puerperae by using uniform questionnaire, amongwhich effective cases were952, at the same time, after interviewing the doctors incharge, we analyzed the causes of cesarean section, checking the maternal pregnancytest records and hospital records, and understand its medical indications of cesareansection.From September2013to October2013, in the antenatal clinic of one hospital inHengyang,200pregnant women who were suitable for eligible pregnancy test wereselected, and the intervention groups and control groups are divided in the order of thepregnant women going to hospital for pregnancy test. The control group of pregnantwomen had the regular prenatal care and prenatal education as usual, while theintervention group on the basis of the comparison implement the intervention of prenatal care health education, which surveyed the two groups of pregnant women thewillingness of the choices of childbirth way and actual delivery ways.Results1. According to the survey,1000cases of maternal cesarean delivery rate was54.52%in Hengyang, the different cesarean section rates of different grade hospitalswere statistically significant (P <0.01), the cesarean delivery rate of private hospitalbeing the highest(71.8%), district maternal and child hospital being the lowest(37.3%).90.69%of the doctors complied with the puerperae’ intension, maternal and familywere the important reasons for the high cesarean section rate (43.55%), the reasonswhy they chose cesarean were attributed to the errors of delivery knowledge(23.57%),the worry of labor pain, choosing the auspicious day, the unbearable pain,polyembryony, precious child, while the cesarean delivery rate of pregnant womenwho have no cesarean section indications was39.86%.2. Different careers, education levels and ages of women’s cesarean deliveryrates were different (P <0.05), the blue-collar workers of unemployed maternalcesarean delivery rate of was42.64%; the cesarean delivery rate of white-collarcesarean was62.33%. Different education levels of maternal cesarean delivery rateshad differences (P <0.05), the higher education level, the higher was the cesareandelivery rate. Different ages of maternal cesarean have different delivery rates (P <0.05), the smaller the age, the lower the cesarean delivery rate. The cesarean deliveryrate of pregnant women over35years old age(81.98%) was higher than all otherages(P<0.05).3. The cesarean rates among the preterm birth, full production, expiredpregnancies and pregnancy complications cesarean were75.27%,50.79%,86.11%,61.36%. The different cesarean delivery rates between preterm birth and expiredpregnancies was not statistically significant (P<0.05), which was higher than full-termproduction rate of cesarean section; pregnancy complications have no influences onmaternal cesarean delivery rate, while the cesarean section rate of pregnant womenwho had maternal Pregnant syndrome was higher than those who hadn’t; the dystociaof cesarean delivery rate was as high as87.5%. 4. Social factors had affected the cesarean delivery rate (OR=9.161, P<0.05), thecesarean delivery rate of local women was higher than the migrant maternal(OR=1.682).5. The differences among the pregnant women’s ages, gestational weeks,household register sources, cultural degrees, occupations, family economic status,health care and the willingness of childbirth ways were not statistically significantbetween the intervention groups and the control group before the health educationintervention(P>0.05).The different willingness of the childbirth ways in theintervention group was statistically significant before and after the delivery(P<0.05),while the contrast group was not(P>0.05). The willingness of puerperae inintervention group who choose natural birth increased and the cesarean deliverydecreased after nursing intervention, and the cesarean rate was lower than the controlgroup’s (P<0.05). After the intervention, the non-medical reasons of cesarean deliverybetween the puerperae are different (P<0.05). Nursing intervention during pregnancycan reduce the puerperae ’ willingness to ask for cesarean delivery because of the fearof labor pain and lacking of related knowledge, but the differences of the cesareandelivery rates between the two groups choosing time to childbirth were notstatistically significant(P<0.05).Conclusions1. The maternal cesarean delivery rate was54.52%in Hengyang, the cesarean sectionrates of different grade hospitals were different, private hospital (71.8%), tertiaryhospitals (53.5%), secondary hospitals (44.8%), district maternal and child hospital(37.3%).2. Social factors are the main cause of high cesarean section rate, the doctorimplementing cesarean delivery under the condition of non-medical reasons, whichcaused the net increase of cesarean delivery rate increased by5.4%.3. Nursing health education intervention for pregnant women is an important measureto reduce the rate of cesarean delivery which can enhance the pregnant womenchoosing natural childbirth willingness. |
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