2015 年佩洛塔斯出生队列研究中分娩过程中对女性的不尊重和虐待。
Disrespect and abuse of women during the process of childbirth in the 2015 Pelotas birth cohort.
机构信息
Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Latin American Center of Perinatology, Women and Reproductive Health, Montevideo, Uruguay.
出版信息
Reprod Health. 2018 Mar 27;15(1):54. doi: 10.1186/s12978-018-0495-6.
BACKGROUND
The disrespect and abuse of women during the process of childbirth is an emergent and global problem and only few studies have investigated this worrying issue. The objective of the present study was to describe the prevalence of disrespect and abuse of women during childbirth in Pelotas City, Brazil, and to investigate the factors involved.
METHODS
This was a cross-sectional population-based study of women delivering members of the 2015 Pelotas birth cohort. Information relating to disrespect and abuse during childbirth was obtained by household interview 3 months after delivery. The information related to verbal and physical abuse, denial of care and invasive and/or inappropriate procedures. Poisson regression was used to evaluate the factors associated with one or more, and two or more, types of disrespectful treatment or abuse.
RESULTS
A total of 4275 women took part in a perinatal study. During the three-month follow-up, we interviewed 4087 biological mothers with regards to disrespect and abuse. Approximately 10% of women reported having experienced verbal abuse, 6% denial of care, 6% undesirable or inappropriate procedures and 5% physical abuse. At least one type of disrespect or abuse was reported by 18.3% of mothers (95% confidence interval [CI]: 17.2-19.5); and at least two types by 5.1% (95% CI: 4.4-5.8). Women relying on the public health sector, and those whose childbirths were via cesarean section with previous labor, had the highest risk, with approximately a three- and two-fold increase in risk, respectively.
CONCLUSIONS
Our study showed that the occurrence of disrespect and abuse during childbirth was high and mostly associated with payment by the public sector and labor before delivery. The efforts made by civil society, governments and international organizations are not sufficient to restrain institutional violence against women during childbirth. To eradicate this problem, it is essential to 1) implement policies and actions specific for this type of violence and 2) formulate laws to promote the equality of rights between women and men, with particular emphasis on the economic rights of women and the promotion of gender equality in terms of access to jobs and education.
背景
分娩过程中对妇女的不尊重和虐待是一个紧急且全球性的问题，只有少数研究调查了这一令人担忧的问题。本研究的目的是描述巴西佩洛塔斯市分娩过程中妇女不被尊重和虐待的发生率，并探讨相关因素。
方法
这是一项基于人群的横断面研究，研究对象为 2015 年佩洛塔斯出生队列的分娩妇女。分娩后 3 个月通过家庭访谈获得有关分娩过程中不尊重和虐待的信息。信息涉及言语和身体虐待、拒绝护理以及侵入性和/或不适当的程序。使用泊松回归评估与一种或多种、两种或多种不尊重的治疗或虐待类型相关的因素。
结果
共有 4275 名妇女参加了围产期研究。在三个月的随访期间，我们对 4087 名亲生母亲进行了关于不尊重和虐待的访谈。大约 10%的妇女报告说经历过言语虐待，6%的妇女报告过拒绝护理，6%的妇女报告过不想要或不适当的程序，5%的妇女报告过身体虐待。至少有一种不尊重或虐待形式的母亲占 18.3%（95%置信区间[CI]：17.2-19.5）；至少两种类型的占 5.1%（95% CI：4.4-5.8）。依靠公共卫生部门的妇女和以前有过劳动的剖宫产分娩的妇女风险最高，风险分别约增加了三倍和两倍。
结论
我们的研究表明，分娩过程中不尊重和虐待的发生率很高，主要与公共部门支付和分娩前劳动有关。民间社会、政府和国际组织所做的努力不足以遏制分娩过程中对妇女的机构暴力。为了消除这一问题，必须 1）实施针对这种类型暴力的政策和行动，2）制定法律，促进男女权利平等，特别强调妇女的经济权利，促进性别平等，包括获得工作和教育的机会。
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