ABSTRACT

Background: Up to 33% of women report a negative or traumatic childbirth experience. Given this high prevalence and its consistent association with adverse postpartum and child outcomes, it is essential to identify predictive factors and to improve the management of the childbirth experience.

Objective: This systematic review explores and identifies risk and protective factors for women’s subjective childbirth experience and birth satisfaction by reviewing original research.

Methods: A systematic search was performed for childbirth experience literature on three online databases. Reviewed papers focused on women’s subjective childbirth experience and its predictive factors. The articles were assessed with the Mixed Methods Appraisal Tool (MMAT).

Results: Risk and protective factors are notably different depending on the study design, the country, or the method employed. The main risk factors are obstetric, such as emergency caesarean and highly perceived labour pain, and women’s dissatisfaction with social support. The main protective factors are: obstetric, including highly perceived control during labour or satisfaction regarding partner’s support. However, overall results are inconclusive for methodological or conceptual reasons.

Conclusions: Several risk factors can be identified through pregnancy or childbirth. This underlines the importance of the quality of maternal interpersonal and professional relationships, especially with first-line perinatal health-care professionals, such as midwives.

摘要

背景：高达 33% 的女性报告有负面或创伤性的分娩经历。鉴于这种高患病率及其与不良产后和儿童结局的一致关联，确定预测因素并改善分娩经历的管理至关重要。

目的：本系统评价通过回顾原始研究来探索和识别女性主观分娩体验和分娩满意度的风险和保护因素。

方法：对三个在线数据库中的分娩经验文献进行系统搜索。审阅的论文集中在妇女的主观分娩经历及其预测因素上。文章使用混合方法评估工具 (MMAT) 进行评估。

结果：风险和保护因素因研究设计、国家或采用的方法而异。主要危险因素是产科，如紧急剖腹产和高度感知的分娩疼痛，以及妇女对社会支持的不满。主要的保护因素是： 产科，包括在分娩过程中高度感知的控制或对伴侣支持的满意度。但是，由于方法或概念原因，总体结果尚无定论。

结论：可以通过怀孕或分娩来确定几个危险因素。这强调了孕产妇人际关系和专业关系质量的重要性，尤其是与一线围产期保健专业人员（如助产士）的关系。