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了解巴西医生对产科暴力的看法以改善对女性的护理。

Understanding the opinion of doctors on obstetric violence in Brazil to improve women's care.

作者信息

Loreto Taís Martins, Kuhn Dos Santos Jorge Francisco, Nomura Roseli Mieko Yamamoto

机构信息

Department of Obstetrics, Escola Paulista de Medicina, Federal University of São Paulo, R Napoleão de Barros, n 875, São Paulo, SP CEP 04024002, Brazil.

Department of Obstetrics, Escola Paulista de Medicina, Federal University of São Paulo, R Napoleão de Barros, n 875, São Paulo, SP CEP 04024002, Brazil.

出版信息

Midwifery. 2022 Jun;109:103294. doi: 10.1016/j.midw.2022.103294. Epub 2022 Feb 25.

Abstract

BACKGROUND

Disrespect and mistreatment in childbirth are human rights violations and must be understood by everyone. However, there are many controversies in the use of the term 'obstetric violence' in Brazil.

OBJECTIVES

To understand the opinion of residents and specialist doctors about obstetric violence and get a balanced view to improve women's care.

SETTING

Public university hospital in São Paulo, Brazil.

PARTICIPANTS

Residents in training and specialist doctors in obstetrics and gynecology.

MEASUREMENTS

Participants answered an electronic form on obstetric violence opinions.

FINDINGS

Of the 60 participants, 33(45%) were specialist doctors and 27(55%) were medical residents in training. Most interviewees (60%) do not agree with the use of the term "obstetric violence" to define mistreatment and disrespectful treatment of women. Regarding situations that characterize obstetric violence, the percentage of residents who agree with the following statements as forms of obstetric violence was significantly (p<0.05) higher than the specialists in the following aspects: episiotomy without consent (78% vs. 15%), episiotomy without indication (100% vs. 64%), episiotomy without anesthesia (96% vs. 76%), not allowing a companion during childbirth (89% vs. 64%), requiring silence from the birthing woman (100% vs. 73%), undergoing vaginal examinations without consent (85% vs. 58%), not allowing the woman to choose childbirth position (82% vs. 58%) and not allowing breastfeeding in the first hour (82% vs. 58%).

CONCLUSIONS AND IMPLICATIONS

The resident doctors in training are aware that the Obstetric Violence typifies the mistreatment and abuse of women during childbirth and the same is not true for specialists. Specialist doctors who completed their training longer ago should undergo training programs for a better understanding of Obstetric Violence.

摘要

背景

分娩过程中的不尊重和虐待行为是侵犯人权的行为,每个人都必须了解这一点。然而,在巴西,“产科暴力”一词的使用存在许多争议。

目的

了解住院医师和专科医生对产科暴力的看法,并获得一个平衡的观点以改善对妇女的护理。

地点

巴西圣保罗的公立大学医院。

参与者

妇产科住院医师和专科医生。

测量方法

参与者回答了一份关于产科暴力看法的电子表格。

研究结果

在60名参与者中,33名(45%)是专科医生,27名(55%)是住院医师。大多数受访者(60%)不同意使用“产科暴力”一词来定义对妇女的虐待和不尊重待遇。关于构成产科暴力的情况,住院医师中同意以下陈述作为产科暴力形式的比例在以下方面显著高于专科医生(p<0.05):未经同意进行会阴切开术(78%对15%)、无指征进行会阴切开术(100%对64%)、无麻醉进行会阴切开术(96%对76%)、分娩时不允许有陪伴人员(89%对64%)、要求产妇保持安静(100%对73%)、未经同意进行阴道检查(85%对58%)、不允许产妇选择分娩姿势(82%对58%)以及不允许在产后第一小时进行母乳喂养(82%对58%)。

结论与启示

接受培训的住院医生意识到产科暴力是分娩期间对妇女的虐待和滥用,而专科医生并非如此。完成培训时间较早的专科医生应参加培训项目,以更好地理解产科暴力。

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