University College London (UCL), 1 - 19 Torrington Place, London, WC1E 6BT, UK.
Leonard Cheshire Research Centre, Department of Epidemiology and Public Health, University College London (UCL), London, UK.
BMC Pregnancy Childbirth. 2019 Jan 9;19(1):20. doi: 10.1186/s12884-019-2171-4.
This study reviews the attitudes and behaviours in rural Nepalese society towards women with disabilities, their pregnancy, childbirth and motherhood. Society often perceives people with disabilities as different from the norm, and women with disabilities are frequently considered to be doubly discriminated against. Studies show that negative perceptions held in many societies undervalue women with disabilities and that there is discomfort with questions of their control over pregnancy, childbirth and motherhood, thus limiting their sexual and reproductive rights. Public attitudes towards women with disabilities have a significant impact on their life experiences, opportunities and help-seeking behaviours. Numerous studies in the global literature concentrate on attitudes towards persons with disabilities, however there have been few studies in Nepal and fewer still specifically on women.
A qualitative approach, with six focus group discussions among Dalit and non-Dalit women without disabilities and female community health volunteers on their views and understandings about sexual and reproductive health among women with disabilities, and 17 face-to-face semi-structured interviews with women with physical and sensory disabilities who have had the experience of pregnancy and childbirth was conducted in Rupandehi district in 2015. Interviews were audio-recorded, transcribed, and translated into English before being analysed thematically.
The study found negative societal attitudes with misconceptions about disability based on negative stereotyping and a prejudiced social environment. Issues around the marriage of women with disabilities, their ability to conceive, give birth and safely raise a child were prime concerns identified by the non-disabled study participants. Moreover, many participants with and without disabilities reported anxieties and fears that a disabled woman's impairment, no matter what type of impairment, would be transmitted to her baby, Participants - both disabled and non-disabled, reported that pregnancy and childbirth of women with disabilities were often viewed as an additional burden for the family and society. Insufficient public knowledge about disability leading to inaccurate blanket assumptions resulted in discrimination, rejection, exclusion and violence against women with disabilities inside and outside their homes. Stigma, stereotyping and prejudice among non-disabled people resulted to exclusion, discrimination and rejection of women with disabilities. Myths, folklore and misconceptions in culture, tradition and religion about disability were found to be deeply rooted and often cited as the basis for individual beliefs and attitudes.
Women with disabilities face significant challenges from family and society in every sphere of their reproductive lives including pregnancy, childbirth and motherhood. There is a need for social policy to raise public awareness and for improved advocacy to mitigate misconception about disability and promote disabled women's sexual and reproductive rights.
本研究回顾了尼泊尔农村社会对残疾女性及其怀孕、分娩和母性的态度和行为。社会往往认为残疾人与众不同,残疾女性经常受到双重歧视。研究表明,许多社会对残疾女性的负面看法低估了她们,对她们控制怀孕、分娩和母性的能力感到不适,从而限制了她们的性和生殖权利。公众对残疾女性的态度对她们的生活经历、机会和寻求帮助的行为有重大影响。全球文献中有许多研究集中在对残疾人的态度上,但尼泊尔的研究很少,专门针对女性的研究就更少了。
2015 年,在尼泊尔鲁潘德希地区,采用定性方法,对 6 组无残疾的达利特和非达利特女性和社区卫生志愿者进行了焦点小组讨论,了解她们对残疾女性性和生殖健康的看法和理解,并对 17 名有怀孕和分娩经历的身体和感官残疾女性进行了 17 次面对面半结构式访谈。访谈进行了录音、转录,并翻译成英文,然后进行主题分析。
研究发现,社会上存在消极的态度,对残疾的误解基于负面的刻板印象和有偏见的社会环境。非残疾研究参与者主要关注残疾女性的婚姻、生育能力、分娩和安全养育子女的能力等问题。此外,许多残疾和非残疾参与者报告说,他们担心残疾女性的残疾,无论残疾类型如何,都会遗传给她的孩子。参与者——包括残疾人和非残疾人——报告说,残疾女性的怀孕和分娩通常被视为家庭和社会的额外负担。公众对残疾的了解不足,导致不准确的一概而论,从而导致残疾女性在家庭内外受到歧视、拒绝、排斥和暴力。非残疾人群中的污名化、刻板印象和偏见导致残疾女性受到排斥、歧视和拒绝。在文化、传统和宗教中关于残疾的神话、民间传说和误解被发现根深蒂固,经常被引用为个人信仰和态度的基础。
残疾女性在怀孕、分娩和母性等生殖生活的各个方面都面临着来自家庭和社会的巨大挑战。社会政策需要提高公众意识,并加强宣传,以减少对残疾的误解,促进残疾女性的性和生殖权利。