Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam University Medical Centre (UMC), Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, The Netherlands.
Reprod Health. 2022 Jul 8;19(1):160. doi: 10.1186/s12978-022-01460-4.
Women experience disrespect and abuse during labour and birth all over the world. While the gravity of many forms of disrespect and abuse is evident, some of its more subtle forms may not always be experienced as upsetting by women. This study examines (1) how often women experience disrespect and abuse during labour and birth in the Netherlands and (2) how frequently they consider such experiences upsetting. We also examine (3) which respondent characteristics (age, ethnicity, educational level and parity) are associated with those experiences of disrespect and abuse that are upsetting, and (4) the associations between upsetting experiences of disrespect and abuse, and women's labour and birth experiences.
Women who gave birth up to five years ago were recruited through social media platforms to participate in an online survey. The survey consisted of 37 questions about experiences of disrespect and abuse divided into seven categories, dichotomised in (1) not experienced, or experienced but not considered upsetting (2) experienced and considered upsetting. A multivariable logistic regression analysis was performed to examine associated characteristics with upsetting experiences of disrespect and abuse. A Chi-square test was used to investigate the association between upsetting experiences of disrespect and abuse and overall birth experience.
13,359 respondents started the questionnaire, of whom 12,239 met the inclusion and exclusion criteria. Disrespect and abuse in terms of 'lack of choices' (39.8%) was reported most, followed by 'lack of communication' (29.9%), 'lack of support' (21.3%) and 'harsh or rough treatment/physical violence' (21.1%). Large variation was found in how frequently certain types of disrespect and abuse were considered upsetting, with 36.3% of women experiencing at least one situation of disrespect and abuse as upsetting. Primiparity and a migrant background were risk factors for experiencing upsetting disrespect and abuse in all categories. Experiencing more categories of upsetting disrespect and abuse was found to be associated with a more negative birth experience.
Disrespectful and abusive experiences during labour and birth are reported regularly in the Netherlands, and are often (but not always) experienced as upsetting. This emphasizes an urgent need to implement respectful maternity care, even in high income countries.
世界各地的女性在分娩期间都经历过不尊重和虐待。虽然许多形式的不尊重和虐待的严重性显而易见，但其中一些更微妙的形式可能并不总是被女性视为令人不安。本研究考察了（1）荷兰女性在分娩期间经历不尊重和虐待的频率，以及（2）她们认为这些经历令人不安的频率。我们还考察了（3）哪些受访者特征（年龄、族裔、教育水平和生育次数）与令人不安的不尊重和虐待经历有关，以及（4）令人不安的不尊重和虐待经历与女性分娩经历之间的关联。
通过社交媒体平台招募了五年内分娩的女性参与在线调查。该调查包括 37 个关于不尊重和虐待经历的问题，分为七个类别，分为（1）未经历或经历但不认为令人不安，以及（2）经历且认为令人不安。采用多变量逻辑回归分析来研究与令人不安的不尊重和虐待经历相关的特征。采用卡方检验来研究令人不安的不尊重和虐待经历与整体分娩经历之间的关联。
13359 名受访者开始了问卷，其中 12239 名符合纳入和排除标准。报告的不尊重和虐待情况中，“缺乏选择”（39.8%）最为常见，其次是“缺乏沟通”（29.9%）、“缺乏支持”（21.3%）和“粗暴或粗暴对待/身体暴力”（21.1%）。某些类型的不尊重和虐待被认为令人不安的频率存在很大差异，36.3%的女性经历过至少一种令人不安的不尊重和虐待情况。初产妇和移民背景是所有类别中经历令人不安的不尊重和虐待的风险因素。经历更多类别的令人不安的不尊重和虐待与更负面的分娩经历相关。
在荷兰，分娩期间不尊重和虐待的经历经常发生，而且往往（但并非总是）被视为令人不安。这强调了即使在高收入国家也迫切需要实施尊重产妇的护理。
