Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland47, av. de Champel, Geneva, CH-1206, Switzerland.
Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, F-69004, France.
BMC Pregnancy Childbirth. 2023 Apr 12;23(1):241. doi: 10.1186/s12884-023-05551-3.
While the World Health Organisation (WHO) warned about mistreatment, disrespect and/or abuse during childbirth as early as 2014. This same year a social media movement with #payetonuterus brought to light the problematic of obstetrical violence in French speaking countries, and more specifically on issues of disrespect. The experience of care is an integral part of the quality of care, and perception on inadequate support during labour and loss of control in labour are some of the most frequently reported risk factors for childbirth-related post-traumatic stress disorder (CB-PTSD). Therefore, it seems crucial to study the associations between disrespect during childbirth and the mental well-being of mothers.
We performed a multicentered cohort study using auto-questionnaires within a French perinatal network. The main outcome was women's report of disrespect during childbirth measured by the Behavior of the Mother's Caregivers - Satisfaction Questionnaire (BMC-SQ) 3 days and 2 months after childbirth. CB-PTSD and Postpartum Depression (PPD) were assessed 2 months after childbirth using respectively the Post-Traumatic Checklist Scale (PCLS) and the Edinburgh Postnatal Depression Scale (EPDS).
This study followed 123 mothers from childbirth to 2 months postpartum. Among them, 8.13% (n = 10/123) reported disrespect during childbirth at 3 days after childbirth. With retrospect, 10.56% (n = 13/123) reported disrespect during childbirth at 2 months postpartum, i.e. an increase of 31%. Some 10.56% (n = 13/123) of mothers suffered from postpartum depression, and 4.06% (n = 5/123) were considered to have CB-PTSD at 2 months after childbirth. Reported disrespect during childbirth 3 days after birth was significantly associated with higher CB-PTSD 2 months after birth (R = 0.11, F(1,117) = 15.14, p < 0.001 and β = 9.11, p = 0.006), PPD at 2 months after childbirth was positively associated to reported disrespect in the birth room, 3 days after birth (R = 0.04, F(1, 117) = 6.28, p = 0.01 and β = 3.36, p = 0.096). Meanwhile, PPD and CB-PTSD were significantly associated 2 months after childbirth (R = 0.41, F=(1,117) = 82.39, p < 0.01 and β = 11.41, p < 0.001).
Disrespect during childbirth was associated with poorer mental health during the postpartum period. Given the high prevalence of mental health problems and the increased susceptibility to depression during the postpartum period, these correlational results highlight the importance of gaining a deeper awareness of healthcare professionals about behaviours or attitudes which might be experienced as disrespectful during childbirth.
早在 2014 年，世界卫生组织（WHO）就警告过分娩期间的虐待、不尊重和/或虐待问题。同年，一场名为#payetonuterus 的社交媒体运动揭示了法语国家产科暴力的问题，特别是在不尊重方面。护理体验是护理质量的一个组成部分，在分娩过程中缺乏支持和失去控制的感知是分娩相关创伤后应激障碍（CB-PTSD）最常报告的风险因素之一。因此，研究分娩期间的不尊重与母亲的心理健康之间的关系似乎至关重要。
我们在法国围产期网络中使用自动问卷进行了一项多中心队列研究。主要结局是女性在分娩后 3 天和 2 个月时通过母亲护理者行为满意度问卷（BMC-SQ）报告的不尊重。分娩后 2 个月使用创伤后检查表量表（PCLS）和爱丁堡产后抑郁量表（EPDS）评估 CB-PTSD 和产后抑郁症（PPD）。
这项研究随访了 123 名从分娩到产后 2 个月的母亲。其中，8.13%（n=10/123）在分娩后 3 天报告不尊重。回顾性地，10.56%（n=13/123）在产后 2 个月报告不尊重，即增加了 31%。10.56%（n=13/123）的母亲患有产后抑郁症，4.06%（n=5/123）在产后 2 个月时被认为患有 CB-PTSD。分娩后 3 天报告的不尊重与分娩后 2 个月时较高的 CB-PTSD 显著相关（R=0.11，F（1,117）=15.14，p<0.001，β=9.11，p=0.006），PPD 与分娩时的不尊重呈正相关房间，3 天后（R=0.04，F（1,117）=6.28，p=0.01，β=3.36，p=0.096）。同时，PPD 和 CB-PTSD 在产后 2 个月时显著相关（R=0.41，F=（1,117）=82.39，p<0.01，β=11.41，p<0.001）。
分娩期间的不尊重与产后期间的心理健康较差有关。鉴于心理健康问题的高患病率以及产后期间对抑郁的易感性增加，这些相关性结果强调了医护人员更深入地了解在分娩过程中可能被视为不尊重的行为或态度的重要性。
