Comparative analysis of natural childbirth and cesarean section on the physiological and psychological effects of puerpera

doi:10.3877/cma.j.issn.1673-5250.2015.03.024

Objective

To investigate physiological and psychological effects of natural childbirth and cesarean section on puerpera.

Methods

A total of 324 cases who were delivered at Second People's Hospital of Liangshan Yi Autonomous Prefecture from February 2013 to February 2014 were included into this study. According to different delivery approaches, they were divided into natural childbirth group (n=126) and cesarean section group (n=198). The following items were observed: postpartum pain scores, recovery of postpartum function(anal exhaust time, incidence rate of abdominal distension, anorexia, >1 week vaginal bleeding time, temperature), maternal mood and lactation. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Second People's Hospital of Liangshan Yi Autonomous Prefecture. Informed consent was obtained from the parents of each patient. There were no significant differences between two groups in the aspects of age, gestational age, weight etc..

Results

①There were significant differences between two groups in pain scores at different time points (P<0.05). ②The anal exhaust time in natural childbirth group was earlier than that in cesarean section group, and incidence rate of abdominal distension, anorexia, >1 week vaginal bleeding time in natural childbirth group were lower than those in cesarean section group with significant differences (P<0.05). The temperature at 1 st, 2 nd day after delivery in natural childbirth group were lower than those in cesarean section group (P<0.05). ③ The proportion of puerpera with good emotion in natural childbirth group was higher than that in cesarean section group (P<0.05). ④ The initial time of lactation in natural childbirth group was earlier than that in cesarean section group (P<0.05).

Conclusions

Natural childbirth could reduce trauma and promote lactation and postpartum recovery.

Key words: Cesarean section, Natural childbirth, Postpartum period, Pain, Emotions, Lactation

表1 两组孕妇产后疼痛评分(分，±s)

Table 1 Comparison of the postpartum pain scores between two groups (socre，±s)

组别	例数	第1天	第2天	第3天
自然分娩组	126	2.6±1.1	2.0±0.9	1.6±0.8
剖宫产组	198	6.2±1.8	5.3±1.7	4.3±1.6
t值	?	18.027	15.390	14.827
P值	?	0.007	0.000	0.000

表1 两组孕妇产后疼痛评分(分，±s)

Table 1 Comparison of the postpartum pain scores between two groups (socre，±s)

组别	例数	第1天	第2天	第3天
自然分娩组	126	2.6±1.1	2.0±0.9	1.6±0.8
剖宫产组	198	6.2±1.8	5.3±1.7	4.3±1.6
t值	?	18.027	15.390	14.827
P值	?	0.007	0.000	0.000

表2 两组产妇产后恢复情况比较[例数(%)]

Table 2 Comparison of the recovery situation between two groups [case (%)]

组别	例数	肛门排气时间(h，±s)	腹胀	厌食	便秘	恶心、呕吐	阴道流血时间>1周
自然分娩组	126	12.9± 7.9	11 (8.7)	18(14.3)	20(15.9)	25(19.8)	27(21.4)
剖宫产组	198	29.2±15.1	34(17.2)	49(24.8)	38(19.2)	44(22.2)	102(51.5)
t值	?	7.579	4.588	5.138	0.577	0.260	28.269
P值	?	0.000	0.032	0.023	0.447	0.610	0.000

表2 两组产妇产后恢复情况比较[例数(%)]

Table 2 Comparison of the recovery situation between two groups [case (%)]

组别	例数	肛门排气时间(h，±s)	腹胀	厌食	便秘	恶心、呕吐	阴道流血时间>1周
自然分娩组	126	12.9± 7.9	11 (8.7)	18(14.3)	20(15.9)	25(19.8)	27(21.4)
剖宫产组	198	29.2±15.1	34(17.2)	49(24.8)	38(19.2)	44(22.2)	102(51.5)
t值	?	7.579	4.588	5.138	0.577	0.260	28.269
P值	?	0.000	0.032	0.023	0.447	0.610	0.000

表3 两组产妇产后体温比较(℃，±s)

Table 3 Comparison of the temperature after the delivery between two groups (℃，±s)

组别	例数	第1天	第2天	第3天
自然分娩组	126	36.8±0.5	36.7±0.5	36.6±0.4
剖宫产组	198	37.2±0.7	37.2±0.7	36.7±0.6
t值	?	5.213	5.682	2.128
P值	?	0.001	0.000	0.140

表3 两组产妇产后体温比较(℃，±s)

Table 3 Comparison of the temperature after the delivery between two groups (℃，±s)

组别	例数	第1天	第2天	第3天
自然分娩组	126	36.8±0.5	36.7±0.5	36.6±0.4
剖宫产组	198	37.2±0.7	37.2±0.7	36.7±0.6
t值	?	5.213	5.682	2.128
P值	?	0.001	0.000	0.140

表4 两组产妇产后情绪比较[例数(%)]

Table 4 Comparison of the postpartum emotion between two groups [case (%)]

组别	例数	情绪良好	情绪低落
自然分娩组	126	91(72.2)	10 (7.9)
剖宫产组	198	121(61.1)	31(15.7)
χ²值	?	4.203	4.152
P值	?	0.040	0.042

表4 两组产妇产后情绪比较[例数(%)]

Table 4 Comparison of the postpartum emotion between two groups [case (%)]

组别	例数	情绪良好	情绪低落
自然分娩组	126	91(72.2)	10 (7.9)
剖宫产组	198	121(61.1)	31(15.7)
χ²值	?	4.203	4.152
P值	?	0.040	0.042

表5 两组产妇产后泌乳情况[例数(%)]

Table 5 Comparison of postpartum lactating situation between two groups [case (%)]

组别	例数	产后开始泌乳时间(h，±s)	乳量充足
自然分娩组	126	27.2±12.8	71(56.4)
剖宫产组	198	31.3±14.9	104(52.5)
χ²值	?	2.031	0.453
P值	?	0.044	0.501

表5 两组产妇产后泌乳情况[例数(%)]

Table 5 Comparison of postpartum lactating situation between two groups [case (%)]

组别	例数	产后开始泌乳时间(h，±s)	乳量充足
自然分娩组	126	27.2±12.8	71(56.4)
剖宫产组	198	31.3±14.9	104(52.5)
χ²值	?	2.031	0.453
P值	?	0.044	0.501

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