Giacomozzi Maddalena, Farje De La Torre Fiorella, Khalil Merette
Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, The Netherlands.
Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Int J Gynaecol Obstet. 2021 Nov;155(2):247-259. doi: 10.1002/ijgo.13890. Epub 2021 Aug 31.
Obstetric violence is a pervasive phenomenon in reproductive health across the world. Denial of the choice in birth position is a common form of obstetric violence as horizontal positions are non-evidence based, yet routinely imposed. This contributes to the cultural barriers to access reproductive health care. The present study compares women's experiences in childbirth from the Quichua and Egyptian communities, exploring the intersectional factors that contribute to obstetric violence and the adoption of preferred birth positions to offer recommendations on implementing respectful and rights-based reproductive care. Two independent scoping reviews have been carried out and subsequently compared. The intersectional approach revealed how gender, race, and class have a multiplicative effect on the denial of choice in birth position as a form of obstetric violence. This phenomenon exacerbates the pre-existing health disparities that disproportionately affect women, indigenous and racialized groups, and people living in poverty. Culturally competent, multilevel, and multidisciplinary interventions, strengthening of health systems, and community participation are essential to combat discrimination and guarantee birth rights. Allowing women to choose their birth position is a low-hanging fruit to challenge the complex issue of obstetric violence and ensure a rights-based approach to reproductive health.
产科暴力是全球生殖健康领域普遍存在的现象。拒绝产妇选择分娩体位是产科暴力的常见形式,因为卧式分娩并无循证依据,却仍被常规采用。这构成了获取生殖健康护理的文化障碍。本研究比较了基切瓦族和埃及社区女性的分娩经历,探究导致产科暴力以及采用偏好分娩体位的交叉因素,以便就实施尊重人权和基于权利的生殖护理提出建议。已开展并随后比较了两项独立的范围综述。交叉性方法揭示了性别、种族和阶级如何对拒绝产妇选择分娩体位这一产科暴力形式产生倍增效应。这种现象加剧了已有的健康差距,这些差距对女性、原住民和种族化群体以及贫困人口的影响尤为严重。具备文化能力的多层次多学科干预措施、加强卫生系统以及社区参与对于消除歧视和保障生育权利至关重要。允许女性选择分娩体位是应对复杂的产科暴力问题并确保基于权利的生殖健康方法的一项轻而易举的举措。