УЧАСТИЕ НА АКУШЕРКАТА В ПРОЦЕСА НА ВЗИМАНЕ НА РЕШЕНИЕ ЗА НА-ЧИНА НА РАЖДАНЕ ОТ ЖЕНИ- НЕ РАЖДАЛИ, БРЕМЕННИ, РАЖДАЛИ БЕЗ ДА ИМАТ АБСОЛЮТНИ ИЛИ ОТНОСИТЕЛНИ ИНДИКАЦИИ ЗА ЦЕЗАРОВО СЕЧЕНИЕ. (Bulgarian)

PARTICIPATION OF THE MIDWIFE IN THE DECISION-MAKING PROCESS OF THE MODE OF BIRTH BY WOMEN- NON-LABORING, PREGNANT, LABORING WITHOUT ABSOLUTE OR RELATIVE INDICATIONS FOR CAESAREAN SECTION. (English)

BULGARIA; TURKEY

Childbirth is a physiological process and usually occurs vaginally and lasts from 4 to 12 hours. There are absolute and relative indications for cesarean section. The object of this study is not the indications for operational birth, but the cases in which they are missing, but women prefer to give birth with surgery. Globally, there is an increase in the percentage of Caesareans performed for no objective reasons compared to vaginal births. This negative trend is observed in a number of countries with relatively high birth rates such as Brazil, Turkey. In EU countries, caesarean sections are within 15-30% of the total number of births. In Bulgaria, almost half of the births are carried out by cesarean section and very few of them are by absolute indications of this. By 2017 the percentage of operations is 45%, and in 2021 it is already 49.95%. The World Health Organization recommends that about 10-15-19% of women give birth surgically. All this data tells us that many of the sections in our country and around the world are unnecessarily done without having an absolute or relative indications for that.Objektive: to examine the opinion and attitudes of non-borne, pregnant, parturient women how they prefer to give birth if they do not have absolute or relative indications for that and what is the involvement of the midwife in forming their opinion.Materials and methods: questing of respondents, observation, interview Results and discussion: There were 984 respondents. The questing of respondents was held from February to 15.04.2023 in Women's Consultations, Departments in Hospitals, Social Networks. More than 70% of women are in favor of a normal vaginal birth, 23% would choose an operative birth without objective prerequisites. When asked how they gave birth, more than half had the answer was operatively 488 and 465 vaginally. The biggest influence on the decision to give birth has the - obstetrician-gynecologists -leading The Consulting Cabinet for Maternal Care/CCMC/ – 86.45% . Very little is the influence of the midwife or a close health care specialist. Respondents' answers indicate that they would contact a midwife working in the Women's Health Kabinet about the choice of birth giving.Positivly answered 864 women and only 147 answered negatively.Conclusion:. The study fulfilled its purpose and showed what is the role of the midwife in making a decision about the woman's mode of delivery, when there are no absolute and relative prerequisites for Caesarean Section at this time. It made it possible, based on the answers, to give some recommendations for increasing the role of the midwife as an active participant in decision-making about the mode of birth. [ABSTRACT FROM AUTHOR]

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