Edin Kerstin E, Högberg Ulf
Department of Public Health and Clinical Medicine, Umeå University, SE 901 85 Umeå, Sweden.
Midwifery. 2002 Dec;18(4):268-78. doi: 10.1054/midw.2002.0318.
to assess the experience, knowledge, attitudes and routines regarding violence against pregnant women among midwives working at antenatal clinics in the county of Västerbotten, northern Sweden.
five qualitative research interviews with midwives were conducted. In addition, questionnaires were sent to all midwives working at the antenatal clinics in the county.
the midwives, although very knowledgeable about and sensitive to pregnant women and their needs, still rarely revealed the occurrence of violence. Symptoms and signals of abuse may vary and are not easily recognised by an outsider. Among pregnant women registered at the antenatal clinic, the midwives roughly estimated that the frequency of known cases of physical and sexual abuse before and during the current pregnancy was 2.3 and 0.6%, respectively for the preceding calendar year. The local programme for antenatal care provided no guidelines regarding response to violence, no instruments for disclosure and no directions about support when confronted with an abused pregnant woman. The midwife did not usually ask any questions if she was merely suspicious but had no strong supporting evidence. In answering the questionnaire however, the midwives were positive towards asking every pregnant woman about abuse in approximately the same way as they asked about other issues already incorporated in the records.
most likely the midwives in this study were disclosing only a fraction of the cases of abuse against women. Violence of this kind will probably remain hidden as long as the whole issue of violence is not included in the national recommendations or in the local programme for antenatal care.
there should be specific written recommendations in the national antenatal care programme to guide and support the midwives in questioning all pregnant women about violence. To achieve adequate and optimal assessment and intervention at the antenatal clinic, the midwives need to be given education and training and provided with a supportive professional network both for themselves and for the abused women.
评估瑞典北部韦斯特博滕郡产前诊所助产士针对暴力侵害孕妇问题的经验、知识、态度和日常工作情况。
对助产士进行了五次定性研究访谈。此外，还向该郡产前诊所的所有助产士发放了问卷。
助产士虽然对孕妇及其需求非常了解且敏感，但仍很少透露暴力事件的发生情况。虐待的症状和信号可能各不相同，外人不易识别。在产前诊所登记的孕妇中，助产士大致估计，在上一个日历年中，已知的当前孕期之前和期间遭受身体虐待和性虐待的案例发生率分别为2.3%和0.6%。当地的产前护理计划没有提供应对暴力的指导方针、披露工具，也没有关于面对受虐孕妇时提供支持的指示。如果助产士只是怀疑但没有有力的支持证据，通常不会问任何问题。然而，在回答问卷时，助产士对于以与询问记录中已包含的其他问题大致相同的方式询问每位孕妇是否遭受虐待持积极态度。
本研究中的助产士很可能只披露了一部分针对女性的虐待案例。只要暴力问题未被纳入国家建议或当地产前护理计划，这类暴力行为可能仍会被隐瞒。
国家产前护理计划应制定具体的书面建议，以指导和支持助产士询问所有孕妇是否遭受暴力。为了在产前诊所进行充分和最佳的评估及干预，需要对助产士进行教育和培训，并为她们自己以及受虐妇女提供支持性的专业网络。
