Doğum Korkusu ve Sezaryen Arasındaki İlişki: Eleştirel Bir İnceleme

Year 2024, Issue: 9, 63 - 75, 30.08.2024

Guldane Kaya

https://doi.org/10.58252/artukluhealth.1540352

Abstract

Giriş: Annenin isteğiyle sezaryen oranlarındaki artış, dünya çapında yaygın bir klinik sorun olarak giderek daha fazla dikkat çekmektedir, Tokofobi (yoğun doğum korkusu) ise bu sorunda potansiyel olarak kritik bir rol oynamaktadır. Tokophobia, anne-bebek bağlanması ve anne ruh sağlığı üzerindeki etkilerine ek olarak gebeliğin sonlandırılması veya tamamen önlenmesi gibi ciddi komplikasyonlara neden olabilir ve gebe kadınların yaklaşık beşte birinin etkilendiği tahmin edilmektedir. Bu çalışmanın amacı, literatürün multipar ve primipar kadınlar arasında doğum korkusu ile sezaryen doğum (elektif veya acil) arasında herhangi bir ilişki olup olmadığını değerlendirmektir.
Yöntem: EMBASE, MEDLINE, Psych INFO ve CINAHL veri tabanlarında Sistematik İncelemeler için Tercih Edilen Raporlama Öğeleri (PRISMA) kullanılarak sistematik bir yaklaşımla eleştirel bir literatür taraması yapılmış ve Ocak 2007 ile Aralık 2022 arasında yayınlanmış hakemli, nitel çalışmalar tespit edilmiştir. Çalışmaların kalitesini değerlendirmek için bir kalite değerlendirmesi kullanılmıştır.
Bulgular: Bu eleştirel literatür taramasına toplam 6 makale dahil edilmiştir. Üç tema belirlenmiştir: 1) Doğum korkusu ve nedenleri, 2) Bir doğum şekli olarak kabul gören sezaryen doğum ve 3) Sezaryen doğumdan kaynaklanan doğum korkusu.
Sonuç: Bu derlemenin bulguları, annelerin doğumla ilgili korku ve kaygılarının temel nedeninin anne ve bebeğe zarar verme korkusu ve doğum bakımının kalitesine ve personelin bağlılığına olan güven eksikliği olduğunu vurgulamıştır. Bu bulgular, doğum şekline ilişkin karar verme sürecinin karmaşıklığı vurgulamaktadır ve gereksiz yere uygulanan sezaryen doğumları potansiyel olarak azaltacak şekilde doğum korkularını gidermek için daha fazla destek ve müdahalelere ihtiyaç duyulduğunu önermektedir. Anne ve bebek sağlığı açısından daha iyi sonuçlar elde etmek amacıyla, tokofobiyi ve bunun doğum yöntemi seçimi üzerindeki etkisini hafifletmeye yönelik etkili stratejilerin araştırılması için daha fazla araştırma yapılması önerilmektedir.

Keywords

Sezaryen, Sezaryen doğum, Doğum korkusu, Tocofobia, Eleştirel inceleme, Derleme

Supporting Institution

Bu çalışma yazarın yüksek lisans öğrenciliğinin bir parçasıdır ve Türkiye Devleti ve Milli Eğitim Bakanlığı tarafından finanse edilmiştir.

The Relationship Between Fear of Childbirth and Caesarean Section: A Critical Review

Abstract

Introduction: The increase in caesarean section rates for maternal requests has gained growing attention as a common clinical problem worldwide, with tokophobia—an intense fear of childbirth—playing a potentially critical role. Tokophobia can cause serious complications such as termination or avoidance of pregnancy altogether, in addition to the implications on maternal-infant attachment and maternal mental health. It is estimated that approximately one-fifth of pregnant women are affected. This study aims to assess if the literature suggests any association between fear of childbirth and giving birth by caesarean section delivery (elective or emergency) among multiparous and primiparous women.
Methods: A critical literature review with a systematic approach using Preferred Reporting Items for Systematic Reviews (PRISMA) of EMBASE, MEDLINE, PsycINFO, and CINAHL databases were identified with peer-reviewed, qualitative studies published between January 2007 and December 2022. A quality appraisal was used to assess the quality of the studies.
Results: A total of six articles were included in this critical literature review. Three themes were identified: 1) fear of childbirth and causes; 2) as a mode of birth, caesarean section; and 3) fear of childbirth associated with caesarean section.
Conclusion: The findings of this review emphasised that the main reasons for maternal fear and anxiety related to birth are fear of damaging the mother and baby, a lack of confidence in the quality of maternity care, and personal commitment. These findings underscore the complexity of the decision-making process regarding the mode of childbirth and suggest a need for enhanced support and interventions to address childbirth fears, potentially reducing unnecessary C-sections. Further research is recommended to explore effective strategies to mitigate tokophobia and its impact on delivery method choice, aiming for better maternal and infant health outcomes.

Keywords

Caesarean section, Caesarean delivery, Fear of childbirth, Tokophobia, Critical literature review, Review

Supporting Institution

This study is part of the author's MSc studentship and is funded by the Turkish Government and the Ministry of National Education.

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