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残疾正义与分娩护理的集体可及性:一项定性研究

Disability justice and collective access to labour and delivery care: a qualitative study.

作者信息

Evans Meredith, Tarasoff Lesley A, Lunsky Yona, Welsh Kate, Proulx Laurie, Havercamp Susan M, Parish Susan L, Brown Hilary K

机构信息

Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada.

Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada.

出版信息

BMC Pregnancy Childbirth. 2024 Dec 20;24(1):832. doi: 10.1186/s12884-024-07036-3.

DOI:10.1186/s12884-024-07036-3
PMID:39707204
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11660975/
Abstract

BACKGROUND

People with disabilities experience perinatal health disparities. This qualitative study examines disabled people's experiences of labour and delivery care from a disability justice lens.

METHODS

Semi-structured interviews were conducted between July 2019 and February 2020 with 31 women and transgender people aged 18-45 years with physical, sensory, and/or intellectual/developmental disabilities, who were living in in Ontario, Canada and had given birth in the previous five years.

RESULTS

People with disabilities described negative experiences of provider-driven, disrespectful, and discriminatory labour and delivery care that can be interpreted as examples of disability injustice and obstetric ableism. People with disabilities also described positive experiences of collaborative, respectful, and disability-affirming labour and delivery care that can be interpreted as examples of disability justice, facilitated by what feminist disability justice scholars and activists call collective access.

CONCLUSIONS

Collective access to labour and delivery care can improve perinatal health care for people with disabilities and promote disability justice. Reimagining care-related decision-making as an interdependent, collaborative, respectful, and disability-affirming process shared between patients and providers can help to facilitate collective access to labour and delivery care.

摘要

背景

残疾人在围产期存在健康差异。本定性研究从残疾正义的视角审视了残疾人在分娩护理方面的经历。

方法

2019年7月至2020年2月期间,对31名年龄在18 - 45岁之间、患有身体、感官和/或智力/发育残疾的女性及跨性别者进行了半结构化访谈,这些人居住在加拿大安大略省,且在过去五年内分娩过。

结果

残疾人描述了由医护人员主导的、不尊重且具有歧视性的分娩护理的负面经历,这些经历可被视为残疾不公正和产科能力主义的例证。残疾人还描述了协作性、尊重性且肯定残疾的分娩护理的积极经历,这些经历可被视为残疾正义的例证,这得益于女性主义残疾正义学者和活动家所称的集体准入。

结论

集体获得分娩护理可改善残疾人的围产期医疗保健,并促进残疾正义。将与护理相关的决策重新构想为患者与医护人员之间相互依存、协作、尊重且肯定残疾的过程,有助于促进集体获得分娩护理。

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本文引用的文献

1
Women with disabilities and their motherhood: scoping review.残疾女性及其母性:范围综述。
Cien Saude Colet. 2024 May;29(5):e09202023. doi: 10.1590/1413-81232024295.09202023. Epub 2023 Jul 9.
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The Disability-Related Education and Training Experiences of Perinatal Care Providers in Ontario.安大略省围产期保健提供者的残疾相关教育和培训经历。
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Prenatal Care Experiences of Childbearing People With Disabilities in Ontario, Canada.加拿大安大略省残疾生育者的产前保健体验。
J Obstet Gynecol Neonatal Nurs. 2023 May;52(3):235-247. doi: 10.1016/j.jogn.2023.02.001. Epub 2023 Mar 17.
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Unmet needs, limited access: A qualitative study of postpartum health care experiences of people with disabilities.未满足的需求,有限的渠道:一项关于残疾人士产后健康护理体验的定性研究。
J Adv Nurs. 2023 Sep;79(9):3324-3336. doi: 10.1111/jan.15642. Epub 2023 Mar 17.
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Barriers to and facilitators of effective communication in perinatal care: a qualitative study of the experiences of birthing people with sensory, intellectual, and/or developmental disabilities.围产期护理中有效沟通的障碍和促进因素:对具有感官、智力和/或发育障碍的产妇的经验的定性研究。
BMC Pregnancy Childbirth. 2022 Apr 26;22(1):364. doi: 10.1186/s12884-022-04691-2.
6
Access to, and experiences of, maternity care for women with physical disabilities: A scoping review.身体残疾女性获得和体验产妇保健服务的情况:范围综述。
Midwifery. 2022 Apr;107:103273. doi: 10.1016/j.midw.2022.103273. Epub 2022 Feb 4.
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Disparities in Severe Maternal Morbidity and Mortality-A Call for Inclusion of Disability in Obstetric Research and Health Care Professional Education.严重孕产妇发病和死亡方面的差异——呼吁在产科研究和医护专业教育中纳入残疾因素
JAMA Netw Open. 2021 Dec 1;4(12):e2138910. doi: 10.1001/jamanetworkopen.2021.38910.
8
Risk of Adverse Maternal Outcomes in Pregnant Women With Disabilities.残疾孕妇不良母婴结局的风险。
JAMA Netw Open. 2021 Dec 1;4(12):e2138414. doi: 10.1001/jamanetworkopen.2021.38414.
9
Recognizing and renaming in obstetrics: How do we take better care with language?产科中的认知与重命名:我们如何在语言方面提供更好的护理?
Obstet Med. 2021 Dec;14(4):201-203. doi: 10.1177/1753495X211060191. Epub 2021 Dec 2.
10
Improved Obstetric Care for People with Disabilities: An Urgent Call for Accessibility and Inclusion.改善残疾人的产科护理:呼吁实现无障碍和包容性的紧急行动。
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