Boston Medical Center and Brigham and Women's Hospital, Boston, Massachusetts.
Obstet Gynecol. 2018 Dec;132(6):1461-1468. doi: 10.1097/AOG.0000000000002956.
To explore the pregnancy and childbirth experiences and preferences of women with a history of sexual trauma in order to identify trauma-informed care practices that health care providers may use to improve obstetric care.
We conducted a qualitative study consisting of semistructured interviews with women who either self-identified as having a history of sexual trauma or did not. Participants were recruited from a tertiary care ambulatory clinic and had at least one birth experience within the past 3 years. Interviews were audio-recorded and transcribed verbatim. Grounded theory was used to derive themes using the participants' own words.
From 2015 to 2017, we interviewed 20 women with a history of sexual trauma and 10 without. Women with a history of sexual trauma desired clear communication about their history between prenatal care providers and the labor and delivery team. In the intrapartum period, they desired control over who was present in the labor room at the time of cervical examinations and for health care providers to avoid language that served as a stressing reminder of prior sexual trauma. They wanted control over the exposure of their bodies during labor and to be asked about their preference for a male health care provider. In the postpartum period, some women with a history of sexual trauma found breastfeeding healing and empowering.
Women with a history of sexual trauma have clear needs, preferences, and recommendations for obstetric care providers regarding disclosure, cervical examinations, health care provider language, body exposure, and male health care providers. They offer insight into unique breastfeeding challenges and benefits.
探讨有性创伤史的女性的妊娠和分娩经历及偏好，以确定医疗保健提供者可以使用哪些以创伤知情为基础的护理实践来改善产科护理。
我们进行了一项定性研究，包括对自我认同有性创伤史或没有性创伤史的女性进行半结构化访谈。参与者是从一家三级保健门诊诊所招募的，且在过去 3 年内至少有一次分娩经历。访谈进行了录音并逐字记录。使用参与者自己的话，采用扎根理论从访谈中推导出主题。
2015 年至 2017 年，我们采访了 20 名有性创伤史的女性和 10 名没有性创伤史的女性。有性创伤史的女性希望产前保健提供者和分娩团队之间能就其病史进行明确沟通。在分娩期间，她们希望能控制在进行宫颈检查时谁在分娩室，并希望医护人员避免使用可能会勾起之前性创伤的压力的语言。她们希望在分娩过程中能控制自己身体的暴露，并被询问对男性医护人员的偏好。在产后期间，一些有性创伤史的女性发现母乳喂养具有治愈和赋权作用。
有性创伤史的女性对披露、宫颈检查、医护人员语言、身体暴露和男性医护人员等方面的产科护理提供者有明确的需求、偏好和建议。她们还提供了有关独特母乳喂养挑战和益处的见解。
