Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK.
Birth. 2019 Mar;46(1):15-23. doi: 10.1111/birt.12390. Epub 2018 Oct 7.
Increasing numbers of childbearing women with a history of female genital mutilation (FGM) are accessing maternity services in high-income countries across the world. For many of these women, their first contact with the health services in their host country is when they are pregnant. While the clinical consequences of certain categories of FGM are well documented, how high-risk maternity services - designed to mitigate the obstetric consequences of FGM - impact upon women's experience of childbearing is less clear.
Using a meta-synthesis approach, this paper synthesizes 12 qualitative research papers, conducted in 5 high-income countries, to explore how migrant women with a history of FGM experience maternity care in their host countries.
One over-arching theme and four discrete subthemes of migrant women's experience of the maternity services in their host country were identified: feelings of alienation; fatalism and divine providence, positive and negative feelings about maternity care, different understandings of the birthing process, and feelings about FGM.
The findings illustrate that migrant women with a history of FGM frequently encounter negative attitudes when accessing the maternity services in their host countries. Women's experiences suggest a concerning absence of sensitive and empathetic care; a more woman-centered approach is recommended.
在全球高收入国家，越来越多有女性割礼史的生育妇女正在获得产科服务。对于这些妇女中的许多人来说，她们与东道国卫生服务机构的第一次接触是在怀孕时。虽然某些类别的女性割礼的临床后果已有充分记录，但旨在减轻女性割礼对产科后果的高风险产科服务如何影响妇女的生育体验，这一点不太清楚。
本文采用元综合方法，综合了在 5 个高收入国家进行的 12 项定性研究论文，探讨了有女性割礼史的移民妇女在东道国如何体验产科护理。
确定了一个总体主题和四个离散的子主题，即移民妇女在东道国的产科服务体验：疏离感；宿命论和神圣天意、对产科护理的积极和消极感受、对分娩过程的不同理解以及对女性割礼的感受。
研究结果表明，有女性割礼史的移民妇女在获得东道国产科服务时经常遇到负面态度。妇女的经历表明，缺乏敏感和同情的护理令人担忧；建议采取更加以妇女为中心的方法。
