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Le libre choix de la voie d'accouchement : Enquête auprès de femmes tunisiennes

Background: The recent overmedication of childbirth process ignores mothers wishes. In Tunisia, women are not involved in decision-making during childbirth.  Aim: To analyze the opinion of a sample of Tunisian women regarding the possibility of making their own informed choices during childbirth and...

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Autores principales: Dimassi, Kaouther, Melki, Meriem, Chebbi, Amal, Rafrafi, Rim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tunisian Society of Medical Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9003588/
https://www.ncbi.nlm.nih.gov/pubmed/35261019
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author Dimassi, Kaouther
Melki, Meriem
Chebbi, Amal
Rafrafi, Rim
author_facet Dimassi, Kaouther
Melki, Meriem
Chebbi, Amal
Rafrafi, Rim
author_sort Dimassi, Kaouther
collection PubMed
description Background: The recent overmedication of childbirth process ignores mothers wishes. In Tunisia, women are not involved in decision-making during childbirth.  Aim: To analyze the opinion of a sample of Tunisian women regarding the possibility of making their own informed choices during childbirth and to determine the factors that may influence the requested mode of delivery. Methods: This was a 5-month descriptive cross-sectional survey. Were included: Tunisian women who were consultants or practitioners at a university obstetrics and gynaecology department in Tunis; female medicine students or members of women dedicated social network groups. The questionnaire was applied during direct interviews or posted online. The main judgment criteria was: participants' opinion regarding access to autonomous choice of delivery mode. Participants were initially enrolled into 2 groups: • group of women requesting access to autonomous choice. • group of women who do not request access to autonomous choice.   The participants were then divided into 2 other groups according to the requested mode of delivery:  • Group : Cesarean section  • Group: Vaginal delivery. A multivariate logistic regression was used to identify risk factors that may have influenced the responses.  Results: The total number of participants was 197. Access to autonomous choice was requested by 63.45% of the participants. These were mainly: consultants: OR=7.76 95% CI [0.56-106.16] or practitioners: OR=3.93 95% CI [0.01-829.03], with a high level of education OR=1.22 95% CI [0-1174.40], with a past positive birth experience: OR=1.24 95% CI [0.27-5.74]. The women who did not claim access to autonomous choices were mainly: doctors OR=-0.31 95% CI [0-32.58], midwives: OR=-0.08, 95% CI [0-18.12] or even housewives OR=-0.42 95% CI [0-68.88]. The women who preferred to give birth by Caesarean section were mainly: practitioners: OR=2.03 95% CI [0.53-7.81], nulliparous OR=2.51 95% CI [0.243-25.98], pregnant OR= 4.44 95% CI [1.03-19.13], with a history of cesarean delivery: OR=5.68 95% CI [0.64- 50.43] or even a history of negative childbirth experience: OR=1.87 95% CI [0.22-15.85]. Conclusion: The request for an Autonomous choice during childbirth most often expresses a certain number of beliefs and fears. Obstetricians should take time to listen and explain, in order to understand the mother's anxieties and enable her to resolve them. Based on the principles of justice, the access to autonomous choices during childbirth process should be universally recognized by legislations and thus fairly respected for all.
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spelling pubmed-90035882022-04-15 Le libre choix de la voie d'accouchement : Enquête auprès de femmes tunisiennes Dimassi, Kaouther Melki, Meriem Chebbi, Amal Rafrafi, Rim Tunis Med Article Background: The recent overmedication of childbirth process ignores mothers wishes. In Tunisia, women are not involved in decision-making during childbirth.  Aim: To analyze the opinion of a sample of Tunisian women regarding the possibility of making their own informed choices during childbirth and to determine the factors that may influence the requested mode of delivery. Methods: This was a 5-month descriptive cross-sectional survey. Were included: Tunisian women who were consultants or practitioners at a university obstetrics and gynaecology department in Tunis; female medicine students or members of women dedicated social network groups. The questionnaire was applied during direct interviews or posted online. The main judgment criteria was: participants' opinion regarding access to autonomous choice of delivery mode. Participants were initially enrolled into 2 groups: • group of women requesting access to autonomous choice. • group of women who do not request access to autonomous choice.   The participants were then divided into 2 other groups according to the requested mode of delivery:  • Group : Cesarean section  • Group: Vaginal delivery. A multivariate logistic regression was used to identify risk factors that may have influenced the responses.  Results: The total number of participants was 197. Access to autonomous choice was requested by 63.45% of the participants. These were mainly: consultants: OR=7.76 95% CI [0.56-106.16] or practitioners: OR=3.93 95% CI [0.01-829.03], with a high level of education OR=1.22 95% CI [0-1174.40], with a past positive birth experience: OR=1.24 95% CI [0.27-5.74]. The women who did not claim access to autonomous choices were mainly: doctors OR=-0.31 95% CI [0-32.58], midwives: OR=-0.08, 95% CI [0-18.12] or even housewives OR=-0.42 95% CI [0-68.88]. The women who preferred to give birth by Caesarean section were mainly: practitioners: OR=2.03 95% CI [0.53-7.81], nulliparous OR=2.51 95% CI [0.243-25.98], pregnant OR= 4.44 95% CI [1.03-19.13], with a history of cesarean delivery: OR=5.68 95% CI [0.64- 50.43] or even a history of negative childbirth experience: OR=1.87 95% CI [0.22-15.85]. Conclusion: The request for an Autonomous choice during childbirth most often expresses a certain number of beliefs and fears. Obstetricians should take time to listen and explain, in order to understand the mother's anxieties and enable her to resolve them. Based on the principles of justice, the access to autonomous choices during childbirth process should be universally recognized by legislations and thus fairly respected for all. Tunisian Society of Medical Sciences 2021-08 2021-08-01 /pmc/articles/PMC9003588/ /pubmed/35261019 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 Unported License. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Article
Dimassi, Kaouther
Melki, Meriem
Chebbi, Amal
Rafrafi, Rim
Le libre choix de la voie d'accouchement : Enquête auprès de femmes tunisiennes
title Le libre choix de la voie d'accouchement : Enquête auprès de femmes tunisiennes
title_full Le libre choix de la voie d'accouchement : Enquête auprès de femmes tunisiennes
title_fullStr Le libre choix de la voie d'accouchement : Enquête auprès de femmes tunisiennes
title_full_unstemmed Le libre choix de la voie d'accouchement : Enquête auprès de femmes tunisiennes
title_short Le libre choix de la voie d'accouchement : Enquête auprès de femmes tunisiennes
title_sort le libre choix de la voie d'accouchement : enquête auprès de femmes tunisiennes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9003588/
https://www.ncbi.nlm.nih.gov/pubmed/35261019
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