关键词: 藏族, 孕妇, 分娩, 横断面研究, 产妇卫生保健服务

Abstract: Objective　To investigate the delivery status of Tibetan pastoral women of childbearing age,and analyze its influencing factors.Methods　In line with the inclusion criteria for the survey,204 women of childbearing age who participated in service activities that benefited the people in Zeku County,Qinghai University from June 19 to 23 in 2014 were selected as the research objects.Among them,80 （39.2%） were from Qiakeri township,79 （38.7%） from Zequ township,and 45 （22.1%） from other townships.The basic information of 204 women of childbearing age was collected,including educational level,marital status,occupation,pregnancy and delivery history;the delivery situation of women who had production history was further investigated,including the selection of midwives,the choice of delivery location,the choice of delivery mode,discomfort symptoms during pregnancy,frequency of prenatal examination,pregnancy-related education receiving status of pregnant women,pregnancy-related education receiving status of the spouse,modern means of transport,economic status;and the influenicing factors of pregnant women choosing different midwives and delivery locations were analyzed.Results　Among the 204 women in childbearing period,their educational level:155 （76.0%） were illiteracy,32（15.7%） were primary school level,10 （4.9%） were junior high school level,and 7 （3.4%） of were high school level or above;marital status:20 （9.8%） of them were unmarried,160 （78.5%） were married,17 （8.3%） were divorced,and 7 （3.4%） of were widowed;occupation:118 （57.8%） were in animal husbandry,25 （12.3%） were housewives,25 （12.3%） were temporary workers,12 （5.9%） of individual busiess households,and 24（11.7%） with others occupations;11 （5.4%） cases with no pregnancy history,193（94.6%） had pregnancy and delivery history.Among the 193 women who had pregnancy and delivery history,191 had production history （including 26 uniparas and 165 multiparas）,and 2 have no history of production.The rate of uniparas choosing medical midwives and institutions was higher than that of multiparas （P<0.05）.There was no significant difference between uniparas and multiparas in the choice of selecting different delivery modes （P>0.05）.Among the uniparas,6 （23.1%） were unmarried,16 （61.5%） married,3 （11.5%） divorced,and 1 （3.9%） widowed;19 （73.1%） owned animal husbandry assets,7 （26.9%） had no animal husbandry assets.The rate of uniparas with the number of antenatal visits was 1 to 4 in selecting midwives was higher than that of uniparas with zero antenatal visit （P<0.05）.There was significant difference in the selection status of midwives and delivery locations between uniparas with or without modern means of transport （P<0.05）;there was no significant difference in the selection status of delivery locations among uniparas with different times of prenatal examination （P>0.05）;there was no significant difference in the selection status of midwives and delivery locations among uniparas of different ages,with or without discomfort symptoms during pregnancy,receiving or not receiving pregnancy-related education,whether their spouses receiving or not receiving pregnancy-related education,and of different economic conditions （P>0.05）.Among the multiparas,4 （2.4%） were unmarried,142 （86.1%） married,13 （7.9%） divorced,and 6 （3.6%） widowed;117 （70.9%） owned animal husbandry assets,48 （29.1%） had no animal husbandry assets.The rate of multiparas with the fetal times≥3 in selecting midwives and delivery locations was lower than that of multiparas with fetal times were 2,the rate of multiparas with the number of antenatal visits≥1 in selecting midwives and delivery locations was higher than that of multiparas with zero antenatal visit （P<0.05）.There was significant difference in the selection status of midwives among multiparas and their spouses receiving or not receiving pregnancy-related education （P<0.05）;there was significant difference in the selection status of delivery locations among multiparas of different economic conditions （P<0.05）;there was no significant difference in the selection status of midwives among multiparas of different economic conditions （P>0.05）;there was no significant difference in the selection status of delivery locations among multiparas and their spouses receiving or not receiving pregnancy-related education （P>0.05）;there was no significant difference in the selection status of midwives and delivery locations among multiparas of different ages and modern means of transport （P>0.05）.Conclusion　The delivering rate of selecting medical institutions and midwifery rate of medical personnel of Tibetan women of childbearing age in Qinghai pastoral area were rather low,and in the choice of medical personnel in midwifery and medical institutions in the delivery of many reasons,families having modern means of transport,fetal times,discomfort symptoms occur during pregnancy,and prenatal examination are the influence factors of delivering in selecting medical midwives and institutions.Therefore,health education targeted at women of childbearing age should be developed according to the actual situation of pastoral areas,and the obstetrics construction of maternity and child care institutions and township hospitals should be strengthened to promote implementation of such health promotion measures.

Key words: Tibetan nationality, Pregnant women, Delivery, Cross-sectional studies, Maternal health services