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产房:它是一个安全的地方吗?对女性负面分娩经历的诠释学分析。

The delivery room: is it a safe place? A hermeneutic analysis of women's negative birth experiences.

作者信息

Nilsson Christina

机构信息

Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden.

出版信息

Sex Reprod Healthc. 2014 Dec;5(4):199-204. doi: 10.1016/j.srhc.2014.09.010. Epub 2014 Oct 8.

Abstract

BACKGROUND

Women's negative experiences in the delivery room can have significance for later fear of childbirth. Therefore, it is important to critically evaluate the care during childbirth. The aim was to gain a deeper understanding of women's negative experiences in the delivery room.

METHODS

This study is based on original data from three qualitative studies on Swedish women's experiences of fear of childbirth. Data were collected from interviews with 21 women; 15 pregnant women (6 + 9) with intense fear of childbirth, and six women who had experienced intense fear of childbirth 7-11 years prior to the interview. The analysis had a hermeneutic approach, with focus on the women's descriptions of their previous negative birth experiences.

FINDINGS

The interpretation showed that in the delivery room the women were objects of surveillance, and they endured suffering related to the care during childbirth. This involves experiences of midwives as uncaring, feelings of being suppressed, unprotected and lacking safety, of feeling disconnected and of the body as incompetent in giving birth. The birth environments are understood as power structures, containing views of women's birthing bodies as machines, and delivery rooms as surveillance environments, involving interventions such as foetal heart monitoring, induction and augmentation of labour.

CONCLUSIONS

The delivery room was, for these women, a place creating fear of childbirth. To avoid negative birth experiences and future fear, women must be offered not only medical, but also emotional and existential safety in the delivery room.

摘要

背景

女性在产房的负面经历可能对日后的分娩恐惧产生影响。因此,批判性地评估分娩期间的护理非常重要。目的是更深入地了解女性在产房的负面经历。

方法

本研究基于三项关于瑞典女性分娩恐惧经历的定性研究的原始数据。数据收集自对21名女性的访谈;15名孕妇(6名+9名)有强烈的分娩恐惧,以及6名在访谈前7至11年经历过强烈分娩恐惧的女性。分析采用诠释学方法,重点关注女性对其先前负面分娩经历的描述。

结果

分析表明,在产房里,女性是被监视的对象,她们忍受着与分娩护理相关的痛苦。这包括助产士冷漠的经历、被压抑、无保护和缺乏安全感的感觉、脱节的感觉以及身体在分娩方面无能的感觉。分娩环境被理解为权力结构,其中包含将女性分娩身体视为机器的观点,以及将产房视为监视环境的观点,涉及诸如胎儿心率监测、引产和加强宫缩等干预措施。

结论

对这些女性来说,产房是一个产生分娩恐惧的地方。为避免负面的分娩经历和未来的恐惧,在产房不仅要为女性提供医疗安全,还要提供情感和生存安全。

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