Ibrahim Bridget Basile, Cheyney Melissa, Vedam Saraswathi, Kennedy Holly Powell
Yale University School of Nursing, 400 West Campus Drive, Orange, CT, 06477, United States.
Oregon State University, Waldo Hall 224, 2250 SW Jefferson Way, Corvallis, OR, 97331, United States.
SSM Qual Res Health. 2023 Dec;4. doi: 10.1016/j.ssmqr.2023.100339. Epub 2023 Oct 3.
In this article, we present findings from a qualitative narrative analysis that examined the pregnancy, primary cesarean, and subsequent birth experiences of women in the United States. Using a maximal variation sampling strategy, we recruited participants via social media and networking to participate in semistructured interviews. Twenty-five women from diverse backgrounds and geographic locations across the U.S. participated, eight self-identified as racialized and seventeen as non-Hispanic, White. Data were analyzed iteratively using Clandinin and Connelly's approach to Narrative Inquiry. Across their narratives, participants described their experiences of maternity care that were either generally negative (dehumanizing care) or positive (humanized care). They further described how their experiences of dehumanizing or humanized care impacted their decision-making for subsequent births, mental health, relationships with the healthcare system, early parenting birth satisfaction, and family planning. Findings suggest that regardless of ultimate mode of birth, what was most important to women was how they are treated by their maternity care team. We suggest practice changes that may improve the experience of maternity care for primary cesarean and subsequent births, especially among those made marginal by systems of oppression.
在本文中，我们展示了一项定性叙事分析的结果，该分析考察了美国女性的怀孕、初次剖宫产及后续分娩经历。我们采用最大差异抽样策略，通过社交媒体和社交网络招募参与者，以参与半结构化访谈。来自美国不同背景和地理位置的25名女性参与了研究，其中8人自我认定为有色人种，17人是非西班牙裔白人。我们使用克兰迪宁和康奈利的叙事探究方法对数据进行了反复分析。在她们的叙述中，参与者描述了她们接受的产科护理经历，这些经历要么总体上是负面的（非人性化护理），要么是正面的（人性化护理）。她们还进一步描述了非人性化或人性化护理经历如何影响她们对后续分娩的决策、心理健康、与医疗系统的关系、初为人母的分娩满意度以及计划生育。研究结果表明，无论最终的分娩方式如何，对女性来说最重要的是她们在产科护理团队那里得到怎样的对待。我们建议做出一些实践改变，以改善初次剖宫产及后续分娩的产科护理体验，尤其是在那些因压迫制度而处于边缘地位的人群中。
