Hungarian Demographic Research Institute, Buday L. str. 1-3, H-1024 Budapest, Hungary.
Sex Reprod Healthc. 2024 Sep;41:101013. doi: 10.1016/j.srhc.2024.101013. Epub 2024 Aug 5.
This study aims to identify discrimination in maternity care experienced by Roma women in Hungary, due to ethnic and socio-economic factors.
We used data from the Cohort'18 Hungarian Birth Cohort Study, covering births in 2018-2019 (n = 7805). Face-to-face interviews were conducted by health visitors during pregnancy and six months postpartum. Differences in obstetric care were tested using Welch's ANOVA. Logistic regression models estimated the influence of Roma ethnicity on birth position, adjusting for socio-economic variables. Odds ratios with 95 % confidence intervals and adjusted predictions were calculated.
Roma mothers had a lower rate of caesarean section due to fewer planned interventions (13.3% vs. 19.1% for non-Roma mothers). Roma women were less likely than non-Roma women to have a birth attended by a private obstetrician (15% vs. 52.6%) and less likely to have a family member present at the birth (40% vs. 65.5%). For vaginal births, 61.3% of Roma women had their birth position dictated by hospital staff, compared with 40.6% of non-Roma women. Ethnic background significantly influenced the choice of birth position, but these associations were attenuated after adjustment for socio-economic and territorial factors. Variables such as the presence of a private obstetrician, family support, and residence in Central Hungary reduced the likelihood of giving birth in a fixed position.
Roma women face significant disadvantages in maternity care in Hungary. Ethnic background has a negative impact on the quality of care, but it is also significantly influenced by adverse socio-economic and regional factors.
本研究旨在识别匈牙利罗姆女性在孕产护理中所经历的种族和社会经济因素导致的歧视。
我们使用了 2018-2019 年“Cohort'18 匈牙利出生队列研究”的数据（n=7805）。孕期和产后 6 个月由健康访视员进行面对面访谈。使用 Welch 的 ANOVA 检验比较产科护理的差异。使用逻辑回归模型调整社会经济变量后，估计罗姆族裔对分娩姿势的影响。计算了 95%置信区间的比值比和调整后的预测值。
由于计划干预较少，罗姆母亲的剖宫产率较低（13.3%比非罗姆母亲的 19.1%）。与非罗姆女性相比，罗姆女性较少接受私人产科医生的分娩（15%比 52.6%），较少有家庭成员在分娩时在场（40%比 65.5%）。对于阴道分娩，61.3%的罗姆女性的分娩姿势由医院工作人员决定，而非罗姆女性为 40.6%。种族背景显著影响分娩姿势的选择，但在调整社会经济和地域因素后，这些关联减弱。私人产科医生的存在、家庭支持和居住在匈牙利中部等变量降低了固定体位分娩的可能性。
在匈牙利，罗姆女性在孕产护理方面面临重大劣势。种族背景对护理质量有负面影响，但也受到不利的社会经济和地区因素的显著影响。
