生殖健康保健预约:加拿大安大略省多伦多市妇产科工作的制度组织如何影响女性外阴残割女性的体验。

Reproductive health care appointments: How the institutional organization of obstetric/gynecological work shapes the experiences of women with female genital cutting in Toronto, Canada.

机构信息

Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

Department of Anthropology, University of Toronto, Toronto, Canada.

出版信息

PLoS One. 2023 Jan 19;18(1):e0279867. doi: 10.1371/journal.pone.0279867. eCollection 2023.

Abstract

We investigated the social relations shaping the reproductive health care experiences of women with female genital cutting (FGC) in Toronto, Canada. Using Institutional Ethnography, we interviewed eight women with FGC and seven obstetrician/gynecologists (OB/GYN). We found a disjuncture between women's needs during appointments that extended beyond the reproductive body and range of care that doctors were able to provide. Women engaged in emotional healthwork during appointments by explaining FGC to doctors, reading doctors' body language, and getting through vulvar/vaginal examinations. Women reported that if they had emotional reactions during appointments, they were often referred to a mental health specialist, a referral on which they did not act. OB/GYNs described their specialty as "surgical"-training centered around treating reproductive abnormalities and not mental health issues. Therefore, the disjuncture between women's needs and OB/GYNs' institutional training highlights the difficulties inherent when bodies of "difference" encounter the reproductive health care system.

摘要

我们调查了在加拿大多伦多影响女性割礼(FGC)经历的社会关系,以了解女性的生殖健康护理体验。我们使用机构民族志方法,采访了 8 名接受过 FGC 的女性和 7 名妇产科医生。我们发现,女性在预约时的需求与医生能够提供的服务之间存在脱节,这些需求不仅限于生殖器官,还包括更广泛的护理范围。女性在预约时通过向医生解释 FGC、解读医生的肢体语言以及完成外阴/阴道检查等方式来进行情感健康工作。女性报告说,如果她们在预约时有情绪反应,通常会被转介给心理健康专家,但她们并没有接受这个转介。妇产科医生将他们的专业描述为“手术”-以治疗生殖异常为中心,而不是心理健康问题。因此,女性的需求与妇产科医生的机构培训之间的脱节凸显了“差异”身体遇到生殖保健系统时所固有的困难。

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