Henriksen Lena, Schei Berit, Lukasse Mirjam
Section of Obstetrics at the Department for Women's and Children's Health, Oslo University Hospital, Postboks 4950 Nydalen, N-0424 Oslo, Norway.
Department of Public Health and General Practice at the Faculty of Medicine, The Norwegian University of Science and Technology (NTNU), Håkon Jarls gate 11, N-7489 Trondheim, Norway; Department of Gynecology at the Women's Clinic, St.Olavs Hospital, Trondheim University Hospital, Postbox 3250 Sluppen, N-7006 Trondheim, Norway.
Midwifery. 2016 May;36:14-20. doi: 10.1016/j.midw.2016.02.018. Epub 2016 Mar 4.
this study aimed to explore the association between lifetime sexual violence and expectations about childbirth.
Norwegian population-based cohort study.
women presenting for routine ultrasound examinations were recruited to the Norwegian Mother and Child Cohort Study between 1999 and 2008.
78,660 pregnant women.
sexual violence and expectations about childbirth were self-reported during pregnancy using postal questionnaires. Risk estimations were performed using multivariable logistic regression analysis and stratified by parity.
fear of childbirth, the thoughts about pain relief, worries about the infant's health and looking forward to the arrival of the infant.
of 78,660 women, 18.4% reported a history of sexual violence and 0.9% were exposed to sexual violence within the last 12 months, including during the current pregnancy. We found that nulliparous women who reported previous or recent sexual violence had a decrease in the odds of looking forward to the arrival of the infant with an AOR of 0.8 (95% CI 0.7-0.9) and 0.4 (95% CI 0.3-0.6), respectively, compared to non-abused women. The same pattern was observed among multiparous women and they were more likely to report worries about the infant's health. Severe sexual violence (rape) was associated with concerns about childbirth, especially for nulliparous women that were more likely to express fear of birth, a hope for a pain-free birth, a desire for caesarean section and worries about the infant's health than non-exposed women.
women with a lifetime exposure to sexual violence, both past experiences and within the last 12 months, were less likely to look forward to the arrival of the infant than non-exposed women, and they were more likely to worry about the infant's health. Women with experiences of severe sexual violence (rape) had more concerns about childbirth than women without this experience. This finding shows that exploring women's attitudes toward childbirth may work as an approach when examining exposure to violence.
本研究旨在探讨终生性暴力与分娩期望之间的关联。
基于挪威人群的队列研究。
1999年至2008年间，参加常规超声检查的女性被纳入挪威母婴队列研究。
78660名孕妇。
在孕期通过邮寄问卷自我报告性暴力情况和分娩期望。采用多变量逻辑回归分析进行风险估计，并按产次分层。
对分娩的恐惧、对疼痛缓解的想法、对婴儿健康的担忧以及对婴儿到来的期待。
在78660名女性中，18.4%报告有性暴力史，0.9%在过去12个月内遭受性暴力，包括在本次孕期。我们发现，与未受虐待的女性相比，报告曾遭受或近期遭受性暴力的初产妇期待婴儿到来的几率分别降低，调整后比值比（AOR）为0.8（95%可信区间[CI] 0.7 - 0.9）和0.4（95% CI 0.3 - 0.6）。经产妇中也观察到同样的模式，且她们更有可能报告对婴儿健康的担忧。严重性暴力（强奸）与对分娩的担忧有关，尤其是初产妇，与未受暴露的女性相比，她们更有可能表达对分娩的恐惧、对无痛分娩的希望、对剖宫产的渴望以及对婴儿健康的担忧。
终生遭受性暴力的女性，无论是过去的经历还是过去12个月内的经历，与未受暴露的女性相比，不太可能期待婴儿的到来，且她们更有可能担心婴儿的健康。有严重性暴力（强奸）经历的女性比没有这种经历的女性对分娩更为担忧。这一发现表明，在调查暴力暴露情况时，探究女性对分娩的态度可能是一种方法。
