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从女性的“不负责任”到胎儿的“病人身份”:意大利和加泰罗尼亚的妇产科医生对堕胎及其污名化的看法。

From women's 'irresponsibility' to foetal 'patienthood': Obstetricians-gynaecologists' perspectives on abortion and its stigmatisation in Italy and Cataluña.

机构信息

a Department of Anthropology , University of Barcelona , Barcelona , Spain.

出版信息

Glob Public Health. 2018 Jun;13(6):711-723. doi: 10.1080/17441692.2017.1293707. Epub 2017 Mar 5.

DOI:10.1080/17441692.2017.1293707
PMID:28278744
Abstract

This article explores obstetricians-gynaecologists' experiences and attitudes towards abortion, based on two mixed-methods studies respectively undertaken in Italy in 2011-2012, and in Spain (Cataluña) in 2013-2015. Short questionnaires and in-depth interviews were conducted with 54 obstetricians-gynaecologists at 4 hospitals providing abortion care in Rome and Milan, and with 23 obstetricians-gynaecologists at 2 hospitals and one clinic providing abortion care in Barcelona. A medical/moral classification of abortions, from those considered 'more acceptable', both medically and morally - for severe foetal malformations - to the 'least acceptable' ones - repeated 'voluntary abortions', emerged in the discourse of most obstetricians-gynaecologists working in public hospitals, regardless of their religiosity. I argue that this is the result of the increasing medicalisation of contraception as well as of reproduction, which has reinforced the stigmatisation of 'voluntary abortion' (in case of unintended pregnancy) in a context of declining fertility rates. This contributes to explain why obstetricians-gynaecologists working in Catalan hospitals, which provide terminations only for medical reasons, unlike Italian hospitals, do not experience abortion stigma and do not object to abortion care as much as their Italian colleagues do.

摘要

本文探讨了妇产科医生对堕胎的经验和态度,这基于分别于 2011 年至 2012 年在意大利和 2013 年至 2015 年在西班牙(加泰罗尼亚)进行的两项混合方法研究。在罗马和米兰提供堕胎服务的 4 家医院,对 54 名妇产科医生进行了简短的问卷调查和深入访谈,在巴塞罗那的 2 家医院和 1 家诊所提供堕胎服务的 23 名妇产科医生进行了同样的访谈。在大多数在公立医院工作的妇产科医生的论述中,出现了一种堕胎的医疗/道德分类,从那些被认为“更可接受”的,无论是从医学上还是从道德上——为严重胎儿畸形——到那些“最不可接受”的——反复“自愿堕胎”。我认为,这是避孕和生殖日益医学化的结果,这种情况加剧了“自愿堕胎”(在意外怀孕的情况下)的污名化,而生育率正在下降。这有助于解释为什么在提供堕胎服务仅限于医疗原因的加泰罗尼亚医院工作的妇产科医生不像意大利医院的同行那样经历堕胎污名,也不那么反对堕胎护理。

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