Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
Women Birth. 2019 Apr;32(2):178-184. doi: 10.1016/j.wombi.2018.05.009. Epub 2018 Jun 15.
Disadvantaged mothers and their babies are at increased risk of poor perinatal outcomes and have less positive experiences of maternity care.
To explore the maternity care experiences of mothers with multiple disadvantages.
A qualitative descriptive study based on semi-structured interviews with 40 mothers with multiple disadvantages, using thematic analysis.
Four themes emerged: 'A confusing and frightening time', 'Longing to be respected as an individual', 'The importance of choice and control', and 'Needing trust to feel safe'. Mothers brought feelings of powerlessness and low self-esteem to their encounters with maternity professionals, which could be significantly worsened by disrespectful care. They needed support to navigate the complex maternity system. Positive experiences were much more likely where the mother had received continuity of care from a specialist midwife or small team.
Mothers with multiple disadvantages value being treated as an individual, making informed choices, and feeling safe, but they may lack the confidence to ask questions or challenge disrespectful treatment. Training and supervision should enable maternity professionals to understand how confusing maternity care can be to very disadvantaged mothers. It should emphasise the need to provide accessible and empowering information and guidance to enable all mothers to make choices and understand the system. Leaders of maternity services need to do more to challenge negative staff attitudes and ensure that that all mothers are treated at all times with kindness, respect and dignity. Specialist midwives can deliver a high quality service to mothers experiencing multiple disadvantages.
处于不利地位的母亲及其婴儿面临更高的围产期不良结局风险，并且对产妇护理的体验较差。
探讨有多重劣势的母亲的产妇护理体验。
基于对 40 名有多重劣势的母亲的半结构式访谈的定性描述研究，采用主题分析。
出现了四个主题：“令人困惑和恐惧的时期”、“渴望被尊重为个体”、“选择和控制的重要性”和“需要信任以感到安全”。母亲在与产妇专业人员接触时带来了无能为力和自尊心低下的感觉，如果护理不尊重，这种感觉可能会大大恶化。他们需要支持来应对复杂的产妇系统。当母亲从专门的助产士或小团队那里获得连续护理时，积极的体验更有可能发生。
有多重劣势的母亲重视被视为个体、做出明智的选择和感到安全，但他们可能缺乏提问或挑战不尊重待遇的信心。培训和监督应使产妇专业人员能够理解对非常不利的母亲来说，产妇护理可能会令人困惑。它应强调提供易于理解和赋权的信息和指导的必要性，以使所有母亲都能够做出选择并了解系统。产妇服务的领导者需要做更多的工作来挑战负面的员工态度，并确保所有母亲在任何时候都能得到友善、尊重和尊严的待遇。专门的助产士可以为有多重劣势的母亲提供高质量的服务。
