Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
PLoS One. 2024 Oct 3;19(10):e0311346. doi: 10.1371/journal.pone.0311346. eCollection 2024.
Mistreatment of women during childbirth is a global health challenge. Maternity healthcare providers play a key role in influencing women's birth experience. This study aimed to assess the knowledge, attitudes, and practices of healthcare providers regarding mistreatment of women during labour and childbirth in public hospitals in Tehran, Iran.
This cross-sectional study was part of an implementation research project that was conducted from October to December 2021 at five public teaching hospitals in Tehran. All eligible maternity healthcare providers (obstetricians and midwives) and students were invited to participate in this study. Data were collected using a questionnaire consisting of four sections: socio-demographic characteristics (11 items), knowledge (11 items), attitudes (13 items), and practices (14 items) about mistreatment. Knowledge, attitude, and practice scores were determined using Bloom's cut-off points. Logistic regression analyses were used to identify the socio-demographic characteristics associated with knowledge and attitudes. A p-value of <0.05 was considered statistically significant.
Of the 270 participants, 255 (94.5%) participated in the study. Majority of the participants (82.7%) had poor knowledge regarding mistreatment of women during labour and childbirth. Poor knowledge was more apparent in the categories of physical abuse, verbal abuse, poor rapport between women and providers, and failure to meet professional standards of care. Most participants (69.4%) had poor attitudes towards mistreatment; they were alright with physical abuse, verbal abuse, and discrimination. Only 3.1% of the participants reported moderate mistreatment practices towards birthing women. Verbal and physical abuse were the most prevalent categories used by the participants. The number of night shifts was associated with attitudes regarding mistreatment (AOR = 0.45, 95% CI = 0.22-0.89, p = 0.02).
The knowledge and attitude of our participants regarding maternity mistreatment were poor. A small percentage of the participants reported mistreatment practices. The findings of our study have important implications for program planners and decision-makers in developing effective interventions to reduce mistreatment of women during labour and childbirth in Iran.
分娩期妇女遭受虐待是全球卫生挑战。产妇保健提供者在影响妇女分娩体验方面发挥着关键作用。本研究旨在评估伊朗德黑兰公立医院中产妇保健提供者在劳动和分娩期间对待妇女的虐待行为的知识、态度和实践。
这是一项横断面研究，是 2021 年 10 月至 12 月在德黑兰五所公立教学医院进行的实施研究项目的一部分。邀请所有符合条件的产妇保健提供者（产科医生和助产士）和学生参加这项研究。数据收集使用了一个由四个部分组成的问卷：社会人口统计学特征（11 项）、知识（11 项）、态度（13 项）和虐待行为（14 项）。知识、态度和实践得分使用 Bloom 的截止点确定。使用逻辑回归分析来确定与知识和态度相关的社会人口统计学特征。p 值<0.05 被认为具有统计学意义。
在 270 名参与者中，255 名（94.5%）参与了研究。大多数参与者（82.7%）对劳动和分娩期间妇女遭受虐待的知识了解甚少。在身体虐待、言语虐待、妇女与提供者之间关系不佳以及未能达到专业护理标准等类别中，知识较差更为明显。大多数参与者（69.4%）对虐待行为持不良态度；他们对身体虐待、言语虐待和歧视持认可态度。只有 3.1%的参与者报告了对分娩妇女的中度虐待行为。言语和身体虐待是参与者中最常见的类别。夜班次数与对虐待的态度有关（OR=0.45，95%CI=0.22-0.89，p=0.02）。
我们参与者对产妇虐待的知识和态度很差。只有一小部分参与者报告了虐待行为。我们研究的结果对方案规划者和决策者制定有效干预措施以减少伊朗劳动和分娩期间妇女遭受虐待具有重要意义。
