Maheen Humaira, Hoban Elizabeth
School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia.
PLoS Curr. 2017 Jan 31;9:ecurrents.dis.7285361a16eefbeddacc8599f326a1dd. doi: 10.1371/currents.dis.7285361a16eefbeddacc8599f326a1dd.
Women are more vulnerable than men in the same natural disaster setting. Preexisting gender inequality, socio-cultural community dynamics and poverty puts women at significant risk of mortality. Pregnant women are particularly vulnerable because of their limited or no access to prenatal and obstetric care during any disaster or humanitarian emergency setting.
In-depth interviews were conducted with 15 women who gave birth during the 2011 floods in Sindh Province, Pakistan. Thematic analysis explored women's experiences of pregnancy and giving birth in natural disaster settings, the challenges they faced at this time and strategies they employed to cope with them. Results: Women were not afforded any control over decisions about their health and safety during the floods. Decisions about the family's relocation prior to and during the floods were made by male kin and women made no contribution to that decision making process. There were no skilled birth attendants, ambulances, birthing or breastfeeding stations and postnatal care for women in the relief camps. Women sought the assistance of the traditional birth attendants when they gave birth in unhygienic conditions in the camps.
The absence of skilled birth attendants and a clean physical space for childbirth put women and their newborn infants at risk of mortality. A clean physical space or birthing station with essential obstetric supplies managed by skilled birth attendants or community health workers can significantly reduce the risks of maternal morbidity and mortality in crisis situations.
在同样的自然灾害环境中,女性比男性更易受到伤害。先前存在的性别不平等、社会文化社区动态以及贫困使女性面临着很高的死亡风险。孕妇尤其脆弱,因为在任何灾难或人道主义紧急情况下,她们获得产前和产科护理的机会有限或根本没有。
对在巴基斯坦信德省2011年洪灾期间分娩的15名女性进行了深入访谈。主题分析探讨了女性在自然灾害环境中怀孕和分娩的经历、她们在此时面临的挑战以及应对这些挑战所采用的策略。结果:在洪灾期间,女性对自身健康和安全的决策没有任何控制权。洪水来临之前和期间关于家庭搬迁的决定由男性亲属做出,女性在这一决策过程中没有任何贡献。救济营中没有熟练的助产士、救护车、分娩或哺乳站,也没有针对女性的产后护理。女性在营地不卫生的条件下分娩时,会寻求传统助产士的帮助。
缺乏熟练的助产士和清洁的分娩空间使女性及其新生儿面临死亡风险。由熟练的助产士或社区卫生工作者管理的、配备基本产科用品的清洁空间或分娩站,可以显著降低危机情况下孕产妇发病和死亡的风险。