Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, Bedfordshire, LU2 8LE, UK.
School of Health Care Practice & Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, Bedfordshire, LU2 8LE, UK.
BMC Pregnancy Childbirth. 2018 Jun 7;18(1):213. doi: 10.1186/s12884-018-1847-5.
Disrespect and abuse (D&A) of women in health facilities continues to be a prevailing public health issue in many countries. Studies have reported significantly high prevalence of D&A among women during pregnancy and childbirth in Nigeria, but little is known about women's perceptions and experiences of D&A during maternity care in the country. The aim of this study was to explore: 1) how women perceived their experiences of D&A during pregnancy, childbirth, and in the postnatal period in Benue State, Nigeria; and 2) how women viewed the impact of D&A on the future use of health facilities for maternity care.
Five focus group discussions with a sample of 32 women were conducted as part of a qualitative phenomenological study. All the women received maternity care in health facilities in Benue State, Nigeria and had experienced at least one incident of disrespect and abuse. Audio-recorded discussions were transcribed and analysed using a six-stage thematic analysis using NVivo11.
The participants perceived incidents such as being shouted at and the use of abusive language as a common practice. Women described these incidents as devaluing and dehumanising to their sense of dignity. Some women perceived that professionals did not intend to cause harm by such behaviours. Emerged themes included: (1) 'normative' practice; (2) dehumanisation of women; (3) 'no harm intended' and (4) intentions about the use of maternity services in future. The women highlighted the importance of accessing health facilities for safe childbirth and expressed that the experiences of D&A may not impact their intended use of health facilities. However, the accounts reflected their perceptions about the inherent lack of choice and an underlying sense of helplessness.
Incidents of D&A that were perceived as commonplace carry substantial implications for the provision of respectful maternity care in Nigeria and other similar settings. As a country with one of the highest rates of maternal deaths, the findings point to the need for policy and practice to address the issue urgently through implementing preventive measures, including empowering women to reinforce their right to be treated with dignity and respect, and sensitising health care professionals.
在许多国家，医疗机构中对女性的不尊重和虐待（D&A）仍然是一个普遍存在的公共卫生问题。研究报告称，在尼日利亚，女性在怀孕期间和分娩期间遭受 D&A 的比例很高，但对于该国女性在分娩期间对 D&A 的看法和体验知之甚少。本研究旨在探讨：1）在尼日利亚贝努埃州，女性如何看待自己在怀孕期间、分娩期间和产后期间的 D&A 经历；2）女性如何看待 D&A 对未来使用医疗机构进行分娩护理的影响。
作为定性现象学研究的一部分，进行了五次焦点小组讨论，样本量为 32 名女性。所有女性都在尼日利亚贝努埃州的医疗机构接受过分娩护理，并且至少经历过一次不尊重和虐待事件。使用 NVivo11 进行六步主题分析对音频记录的讨论进行转录和分析。
参与者认为被大声喊叫和使用辱骂性语言等事件是常见做法。女性将这些事件描述为贬低和剥夺尊严的行为。一些女性认为专业人员并非故意通过这种行为造成伤害。出现的主题包括：（1）“规范”做法；（2）女性的非人化；（3）“无意伤害”和（4）未来使用分娩服务的意图。女性强调为了安全分娩而获得医疗保健的重要性，并表示对 D&A 的体验可能不会影响她们对医疗保健设施的预期使用。然而，这些描述反映了她们对缺乏选择的固有看法和无助感。
被视为司空见惯的 D&A 事件对在尼日利亚和其他类似环境中提供尊重女性的分娩护理具有重大意义。作为一个孕产妇死亡率最高的国家之一，研究结果表明，需要通过实施预防措施，包括赋予妇女权力以维护其受尊重和尊严的权利，并提高卫生保健专业人员的意识，紧急解决这一问题。
