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临产和分娩的准备

Author
Judith A Lothian, RN, PhD, LCCE
Section Editor
Charles J Lockwood, MD, MHCM
Deputy Editor
Kristen Eckler, MD, FACOG
Translators
徐琳, 教授

引言

女性的分娩经历极为重要，其关于分娩的记忆往往可持续很长一段时间[1,2]。女性的分娩经历取决于4个非常重要的因素：个人期望、得到的支持程度、医患关系的质量，以及女性在决策制定过程中的参与程度[3]。

本文将总结帮助女性为临产和分娩做准备的目标和教育方法。与妊娠相关的其他专题将单独讨论(参见“初次产前评估及早期妊娠产前保健”和“产前检查(中晚期妊娠)”和“小组产前保健”)

背景

女性一直都做好了分娩胎儿的准备。传统上，不论来自何种文化背景的母亲都会为他们的女儿传授临产和分娩方面的知识。这些文化和家庭的习俗引导着女性从妊娠、临产、分娩，直到成为新母亲。但自从分娩从家里转移到医院后，女性对分娩的许多知识就逐渐消失了。母亲、姐妹和其他有分娩知识的女性不再参与照顾分娩的女性。分娩变成了一个医疗事件，而文化和家庭习俗则逐渐让位，最终几乎彻底消失[4]。随着传统信息分享方式的消弭，取而代之的是针对分娩准备的结构化教育项目[4,5]。对妊娠、临产和分娩的机制和医疗处理有深入了解的护士和物理治疗师们担负起了对女性进行分娩的教育任务，而这通常是在医疗保健体系外完成的。最终，这些专业人员经过正式培训成为了分娩教育者[5]。在最初几年中，分娩教育着重于两个方面：一是临产和分娩的基本解剖学和生理学，二是应对宫缩疼痛的简单策略(通常是放松和呼吸)。

如今，我们在一些方面已有了深入的认识，包括：临产时疼痛的作用[6]、可使女性在临产和分娩期间感觉到舒适的方式非常广泛并且还在日益增加[7]，以及分娩期间持续的情感和身体支持的重要性[8-10]。此外，对照研究证实，在临产期间运动、生理性向下用力[11,12]及在第二产程时保持直立体位等传统分娩技巧是行之有效的手段[13,14]。与40年前的女性相比，现在的女性在临产及分娩准备方面的知识要丰富得多。

临产和分娩准备的目标

分娩教育的主要目标是使女性具备以下能力[15,16]：

         

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Literature review current through: 2017-06 . | This topic last updated: 2017-06-19.
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