University of Michigan Medical School, Ann Arbor, Michigan; the School of Social Service Administration, University of Chicago, Chicago, Illinois; the Department of Surgery, University of Massachusetts, Worcester Massachusetts; and the Department of Obstetrics and Gynecology, Michigan Medicine, Ann Arbor, Michigan.
Obstet Gynecol. 2021 Apr 1;137(4):717-722. doi: 10.1097/AOG.0000000000004297.
Although reproductive injustices and reproductive health disparities are well-documented in the United States, recent studies have begun to explore the health care professional's role in their perpetuation. We hypothesized that obstetrics and gynecology residents would observe reproductive injustices during their training. Thus, using a national survey, we asked obstetrics and gynecology residents to share clinical cases in which discrimination, bias, inequity, or injustice was involved in a patient's reproductive health care and queried their preparedness to respond. Through qualitative analysis, we found that respondents shared cases involving racism, discrimination, and structural barriers to care and that they felt poorly equipped to handle injustice. We call for clinician educators to combat reproductive injustice through three key changes to obstetrics and gynecology residency training: 1) incorporate reproductive justice training into formal residency education; 2) create safe spaces for residents to collectively debrief about their experiences with injustice and collaborate on care improvement; and 3) teach community engagement and advocacy skills that identify, center, and elevate local reproductive health priorities.
尽管生殖不公和生殖健康差异在美国有大量记录，但最近的研究已经开始探讨医疗保健专业人员在其延续中的作用。我们假设妇产科住院医师在培训期间会观察到生殖不公现象。因此，我们使用一项全国性调查，要求妇产科住院医师分享涉及歧视、偏见、不平等或不公正的患者生殖保健的临床案例，并询问他们应对的准备情况。通过定性分析，我们发现受访者分享了涉及种族主义、歧视和护理结构性障碍的案例，他们觉得自己处理不公的能力很差。我们呼吁临床医生教育者通过对妇产科住院医师培训进行三项关键改革来打击生殖不公：1）将生殖公正培训纳入正式住院医师教育；2）为住院医师创造安全空间，让他们集体反思自己在不公正待遇方面的经历，并共同改进护理；3）教授社区参与和宣传技能，以确定、关注和提升当地生殖健康重点。
