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分娩方式决策是一个由卫生服务供方和患者需方共同参与的过程,基于特定情境和孕产妇价值观的充分考量;帮助每位妊娠妇女获取最佳分娩方式是产科专业人员提供以孕产妇为中心的高质量照护服务的关键.随着先进医疗技术在我国的引入,产前监测手段的过度使用、剖宫产指征的放宽、人们错误认识等原因,使我国剖宫产呈现急剧上升趋势.生育政策的最新调整或引发众多家庭生育意愿和行为的变化,进而影响至对于后阶段分娩方式的思考和抉择.笔者从分娩方式的利弊分析、分娩方式决策过程、供需方影响因素以及分娩方式决策支持策略等方面进行阐述,有助于产科专业人员在现阶段生育新政背景下更好地为孕产妇及其家庭提供基于最佳实证的分娩方式决策支持服务.

Decision on mode of delivery (MOD) is a process involved by both clients and health care providers, based on specific clinical situations and women′s values. To help each woman obtain the best MOD is crucial for obstetric health professionals to provide women-centered high quality of care. There is a steep upward trend in cesarean sections in China due to the introduced advanced technologies, overused antenatal monitoring methods, flexible indications for cesarean sections, delayed childbearing ages and people′s misconceptions, etc.. Recently the conditional and comprehensive two-child policy have been implemented in China, which might initiate changes in fertility and birth intentions of many families, and in subsequent decisions on MOD. This review illustrates the pros and cons of MOD, decision process on MOD, influencing factors and strategies to promote decision on MOD, in order for the obstetric professionals to provide evidence-based best care for women and their families in the process of decision-making.