Département de médecine générale, UFR médecine, Université Clermont Auvergne, Clermont-Ferrand, France.
Université Clermont Auvergne, UR ACCePPT, Clermont-Ferrand, France.
Health Expect. 2022 Oct;25(5):2255-2263. doi: 10.1111/hex.13472. Epub 2022 Jun 15.
Socioeconomic deprivation (SED) is a risk factor for complications during pregnancy and childbirth, the impact of which has been studied poorly in rural areas.
To explore the perceptions and behaviour of women living in SED in a rural area with regard to their pregnancy follow-up.
A qualitative study using semi-structured individual interviews was carried out in a rural area in central France. To participate, the women had to have an Evaluation of Deprivation and Inequalities in Health Examination Centres deprivation score ≥ 30.17, be living in a rural area and have given birth during the month before the interview. The interviews were analysed using a thematic approach inspired by grounded theory.
Seventeen women were interviewed. The difficulties of life in a rural area were linked to geographical remoteness, travel costs, lack of public services, inadequacy of nearby healthcare and social isolation. In all cases, pregnancy was an additional difficulty. The adaptive capability was related to the presence of an efficient family and social network. Most of the time, any increase in the limitations exceeded the ability to adapt and affected the medical follow-up of the pregnancy, although follow-up appointments were rarely abandoned altogether. Perceptions of birth preparation and parenting sessions were often limited to advice on pain management. Due to their affiliation with their rural area or their choice of lifestyle, the women complained only minimally.
Women often minimize any limitations and implement adaptive techniques that make identification by social and medical services more difficult.
Eighteen women in SED were contacted by Childhood Medical Protection, midwives and general practitioners practising in rural areas. One woman declined participation and seventeen were interviewed.
社会经济剥夺（SED）是妊娠和分娩期间并发症的一个风险因素，但在农村地区，对其影响的研究甚少。
探讨农村地区处于社会经济剥夺中的妇女对其妊娠随访的认知和行为。
在法国中部的一个农村地区进行了一项定性研究，采用半结构式个体访谈。参与研究的妇女必须满足以下条件：在健康中心评估剥夺和不平等状况中得分≥30.17、生活在农村地区、在访谈前一个月分娩。使用受扎根理论启发的主题方法对访谈进行分析。
共访谈了 17 名妇女。农村地区生活的困难与地理位置偏远、交通费用、缺乏公共服务、附近医疗保健不足和社会隔离有关。在所有情况下，妊娠都是一个额外的困难。适应能力与有效的家庭和社会网络的存在有关。大多数情况下，任何限制的增加都超过了适应能力，并影响了妊娠的医疗随访，尽管很少有妇女完全放弃随访预约。对分娩准备和育儿课程的认识往往仅限于疼痛管理方面的建议。由于她们与农村地区的联系或生活方式的选择，这些妇女的抱怨很少。
妇女经常最小化任何限制，并采用适应性技术，这使得社会和医疗服务部门更难发现问题。
通过儿童医疗保护、农村地区的助产士和全科医生联系了 18 名处于社会经济剥夺中的妇女。一名妇女拒绝参与，共有 17 名妇女接受了访谈。
