Department of Public Health, Sefako Makgatho Health Sciences University, P.O. Box 215 Medunsa 0403, Pretoria 0001, South Africa.
Int J Environ Res Public Health. 2020 May 22;17(10):3667. doi: 10.3390/ijerph17103667.
The disrespect and abuse (D&A) of women during childbirth is common and a great concern in midwifery-led obstetric units (MOUs) in South Africa. This paper used the seven chapters of the Respectful Maternity Care Charter as a framework to explore women's experiences of care during childbirth and examine the occurrence of D&A during childbirth in MOUs. Five focus group interviews were conducted with postnatal women aged 18 to 45 years selected purposively from MOUs in Tshwane District in South Africa. The discussions were audio-recorded, transcribed, and analyzed using a thematic approach and NVivo11 computer software. D&A of women was common during labor and childbirth. Verbal abuse in the form of shouting, labeling, judging, and rude remarks was the common form of D&A. Some of the women were abandoned and neglected, which resulted in their giving birth without assistance. Furthermore, the midwives violated their rights and denied them care such as pain relief medication, birth companions during childbirth, and access to ambulance services. Midwives are at the center of the provision of maternity care in MOUs in South Africa. Therefore, there is a need to strengthen interventions to adopt and implement policies that promotes respectful, nonabusive care during childbirth in MOUs.
在南非助产士主导的产科单位（MOUs）中，分娩过程中对女性的不尊重和虐待（D&A）很常见，也令人深感担忧。本文以尊重产妇护理宪章的七个章节为框架，探讨了女性在分娩过程中的护理体验，并研究了 MOUs 中分娩过程中发生的 D&A 现象。我们在南非茨瓦内地区的 MOUs 中，采用目的性抽样的方法，选取了 18 至 45 岁的产后女性，进行了五组焦点小组访谈。讨论内容被录音、转录，并使用主题分析和 NVivo11 计算机软件进行分析。分娩过程中对女性的不尊重和虐待很常见。口头辱骂，如大喊大叫、贴标签、评判和粗鲁的言论，是 D&A 的常见形式。一些女性被忽视和遗弃，导致她们在无人帮助的情况下分娩。此外，助产士侵犯了她们的权利，拒绝为她们提供护理，如止痛药、分娩时的陪伴以及使用救护车服务。助产士是 MOUs 中提供产妇护理的核心人员。因此，有必要加强干预措施，采取和实施政策，以促进 MOUs 中尊重、非虐待性的分娩护理。
