Global Health Research Institute, Faculty of Social Sciences, University of Southampton, United Kingdom. Electronic address: https://www.twitter.com/myheroistrane.
Global Health Research Institute, Faculty of Social Sciences, University of Southampton, United Kingdom.
Women Birth. 2022 Feb;35(1):e49-e59. doi: 10.1016/j.wombi.2021.02.003. Epub 2021 Mar 5.
Disrespect and abuse during childbirth can result in fear of childbirth. Consequently, women may be discouraged to seek care, increasing the likelihood for women to choose elective cesarean section in order to avoid humiliation, postnatal depression and even maternal mortality. This study investigates the causes underlying mistreatment of women during childbirth by health care providers in India, where evidence of disrespect and abuse has been reported.
Qualitative research was undertaken involving 34 in-depth interviews with midwifery and nursing leaders from India who represent administration, advocacy, education, regulation, research and service provision at state and national levels. Data are analysed thematically with NVivo12. The analysis added value by bringing an international perspective from interviews with midwifery leaders from Switzerland and the United Kingdom.
The factors leading to disrespect and abuse of women relate to characteristics of both women and their midwives. Relevant woman-related attributes include her age, gender, physical appearance and education, extending to the social environment including her social status, family support, culture of abuse, myths around childbirth and sex-based discrimination. Midwife-related factors include gender, workload, medical hierarchy, bullying and powerlessness.
The intersectionality of factors associated with mistreatment during childbirth operate at individual, infrastructural, social and policy levels for both the women and nurse-midwives, and these factors could exacerbate existing gender-based inequalities. Maternal health policies should address the complex interplay of these factors to ensure a positive birthing experience for women in India.
Maternal health interventions could improve by integrating women-centred protocols and monitoring measures to ensure respectful and dignified care during childbirth.
分娩过程中的不尊重和虐待会导致产妇对分娩产生恐惧。因此，女性可能会不愿意寻求护理，这增加了她们选择择期剖宫产的可能性，以避免羞辱、产后抑郁甚至产妇死亡。本研究调查了在印度，医疗保健提供者对产妇进行虐待的原因，因为那里有不尊重和虐待的证据。
进行了定性研究，涉及来自印度的 34 名助产士和护士领导人的 34 次深入访谈，他们代表州和国家各级的行政、宣传、教育、监管、研究和服务提供。使用 NVivo12 对数据进行主题分析。通过对来自瑞士和英国的助产士领导人的访谈，分析增加了国际视角。
导致不尊重和虐待妇女的因素与妇女及其助产士的特征有关。与妇女有关的相关属性包括她的年龄、性别、外貌和教育程度，延伸到包括她的社会地位、家庭支持、虐待文化、分娩神话和性别歧视在内的社会环境。与助产士有关的因素包括性别、工作量、医疗等级制度、欺凌和无能为力。
与分娩期间虐待有关的因素的交叉性在妇女和护士助产士的个人、基础设施、社会和政策层面上运作，这些因素可能会加剧现有的性别不平等。产妇健康政策应解决这些因素的复杂相互作用，以确保印度妇女有一个积极的分娩体验。
通过整合以妇女为中心的协议和监测措施，改善产妇健康干预措施，以确保分娩过程中得到尊重和有尊严的护理。
