Department of Midwifery Science, AVAG, Amsterdam Public Health research institute, Amsterdam UMC, VU medical centre, Amsterdam, The Netherlands.
Department of Obstetrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands.
PLoS One. 2020 May 12;15(5):e0233114. doi: 10.1371/journal.pone.0233114. eCollection 2020.
Disrespect and abuse during labour and birth are increasingly reported all over the world. In 2016, a Dutch client organization initiated an online campaign, #genoeggezwegen (#breakthesilence) which encouraged women to share negative and traumatic maternity care experiences. This study aimed (1) to determine what types of disrespect and abuse were described in #genoeggezwegen and (2) to gain a more detailed understanding of these experiences.
A qualitative social media content analysis was carried out in two phases. (1) A deductive coding procedure was carried out to identify types of disrespect and abuse, using Bohren et al.'s existing typology of mistreatment during childbirth. (2) A separate, inductive coding procedure was performed to gain further understanding of the data.
438 #genoeggezwegen stories were included. Based on the typology of mistreatment during childbirth, it was found that situations of ineffective communication, loss of autonomy and lack of informed consent and confidentiality were most often described. The inductive analysis revealed five major themes: ''lack of informed consent"; ''not being taken seriously and not being listened to"; ''lack of compassion"; ''use of force"; and ''short and long term consequences". "Left powerless" was identified as an overarching theme that occurred throughout all five main themes.
This study gives insight into the negative and traumatic maternity care experiences of Dutch women participating in the #genoeggezwegen campaign. This may indicate that disrespect and abuse during labour and birth do happen in the Netherlands, although the current study gives no insight into prevalence. The findings of this study may increase awareness amongst maternity care providers and the community of the existence of disrespect and abuse in Dutch maternity care, and encourage joint effort on improving care both individually and systemically/institutionally.
在世界各地，越来越多的人报告称在分娩期间遭受了不尊重和虐待。2016 年，一家荷兰客户组织发起了一项在线活动#genoeggezwegen（#打破沉默），鼓励女性分享负面和创伤性的产妇护理经历。本研究旨在：（1）确定#genoeggezwegen 中描述的哪些类型的不尊重和虐待；（2）更详细地了解这些经历。
采用定性社交媒体内容分析法，分两个阶段进行。（1）采用 Bohren 等人现有的分娩期间虐待行为分类法，进行演绎式编码程序，以确定不尊重和虐待的类型。（2）进行单独的、归纳式编码程序，以进一步了解数据。
共纳入 438 个#genoeggezwegen 故事。根据分娩期间虐待行为的分类法，发现沟通不畅、自主权丧失、缺乏知情同意和保密等情况最为常见。归纳分析揭示了五个主要主题：“缺乏知情同意”；“不被认真对待和倾听”；“缺乏同情心”；“使用武力”；和“短期和长期后果”。“无能为力”被确定为贯穿所有五个主要主题的一个总体主题。
本研究深入了解了参与#genoeggezwegen 活动的荷兰女性的负面和创伤性产妇护理经历。这可能表明，在荷兰分娩期间确实存在不尊重和虐待行为，尽管目前的研究无法了解其普遍性。本研究的结果可能会提高产妇保健提供者和社区对荷兰产妇保健中存在的不尊重和虐待行为的认识，并鼓励个人和系统/机构共同努力改善护理。
