Wellington Molly, Hegarty Kelsey, Tarzia Laura
Department of General Practice, The University of Melbourne, 780 Elizabeth Street, Melbourne, Vic, Australia.
Centre for Family Violence Prevention, The Royal Women's Hospital, Melbourne, Australia.
BMC Health Serv Res. 2021 May 4;21(1):424. doi: 10.1186/s12913-021-06420-5.
Reproductive coercion and abuse is defined as any behaviour that seeks to control a woman's reproductive autonomy. In Australia, women often access reproductive health care through a primary care clinician, however, little is known about clinicians' experiences responding to reproductive coercion and abuse. This study aims to address this gap by exploring the barriers to responding to reproductive coercion and abuse in Australian primary care.
In this qualitative study, twenty-four primary care clinicians from diverse clinical settings in primary care across Australia were recruited to participate in a semi-structured interview. Data were analysed thematically.
Through analysis, three themes were developed: It's not even in the frame; which centred around clinicians lack of awareness around the issue. There's not much we can do, where clinicians described a lack of confidence in responding correctly as well as a lack of services to refer on to. Lastly There's no one to help us, explaining the disconnect between referral services and primary care as well as the impacts of lack of abortion on women experiencing reproductive coercion and abuse.
Clinicians expressed similar experiences of barriers to respond to reproductive coercion and abuse. Many clinicians felt ill-equipped to identify and respond to reproductive coercion and abuse. Some clinicians hadn't received any formal training, others were trained but had nowhere to refer women. Further complicating responses was a lack of support from referral services. This study highlights the need for more training and a streamlined referral pathways for women who experience reproductive coercion and abuse, as well as better access to reproductive health services in rural areas.
生殖胁迫与虐待被定义为任何试图控制女性生殖自主权的行为。在澳大利亚，女性通常通过初级保健临床医生获得生殖健康护理，然而，对于临床医生应对生殖胁迫与虐待的经历知之甚少。本研究旨在通过探索澳大利亚初级保健中应对生殖胁迫与虐待的障碍来填补这一空白。
在这项定性研究中，招募了来自澳大利亚各地初级保健不同临床环境的24名初级保健临床医生参与半结构化访谈。对数据进行了主题分析。
通过分析，形成了三个主题：“甚至不在框架内”，该主题围绕临床医生对该问题缺乏认识；“我们能做的不多”，临床医生描述了在正确应对方面缺乏信心以及缺乏可转诊的服务；最后是“没人能帮我们”，解释了转诊服务与初级保健之间的脱节以及缺乏堕胎服务对遭受生殖胁迫与虐待的女性的影响。
临床医生表达了在应对生殖胁迫与虐待方面类似的障碍经历。许多临床医生感到缺乏识别和应对生殖胁迫与虐待的能力。一些临床医生没有接受过任何正规培训，另一些接受过培训但无处可将女性转诊。转诊服务缺乏支持使应对措施更加复杂。本研究强调需要为遭受生殖胁迫与虐待的女性提供更多培训和简化的转诊途径，以及改善农村地区获得生殖健康服务的机会。
