Masoi Theresia J, Mselle Lilian Teddy, Kibusi Stephen M, Sirili Nathanael
Department of Clinical Nursing, the University of Dodoma, Dodoma, Tanzania.
Department of Clinical Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
SAGE Open Nurs. 2025 Jul 17;11:23779608251361015. doi: 10.1177/23779608251361015. eCollection 2025 Jan-Dec.
Violence during pregnancy, childbirth and after childbirth is a critical issue globally. There remains a lack of consensus on operational definitions of the components across different cultures globally since the definitions of respect, disrespect and violence can differ among cultures, traditions and places. Obstetric violence presents a significant barrier to seeking facility-based care during pregnancy and childbirth and instead women may opt for home deliveries with unskilled attendants. As a result, some experience complications thus contributing to the high prevalence of maternal mortality and morbidity.
To explore the contextual components of obstetric violence as perceived by postnatal mothers, health care providers and key community informants in central zone Tanzania.
An exploratory qualitative case study employed in-depth interviews with purposefully selected 24 postnatal mothers, 18 healthcare providers, and 4 religious leaders. Additionally, 6 focus group discussions were conducted with male partners, community health workers, and 10-cell leaders. Data analysis followed qualitative content analysis process, incorporating both inductive and deductive approaches.
Nine categories of obstetric violence experienced by women during health facility care emerged from the analysis. These categories are lack of supportive care and treatment, autonomy limitations, non-consented care, compromised privacy and confidentiality, painful routine procedures that are not evidence-based, verbal violence, sexual violence, stigma and discrimination, emotional violence. Additionally, six categories of obstetric violence emerged related to experiences of women at the community level. They included: forceful insertion of herbs to the vagina, verbal violence, physical violence, psychological violence, forced home delivery and inappropriate sexual practices.
Contextual components gathered by this study help to better define obstetric violence in the Tanzanian context and serve as a reference. This might help to validate measurement methods, and provide a pathway for developing evidence-based interventions to reduce obstetric violence and promote respectful maternity care.
孕期、分娩期间及分娩后的暴力行为是一个全球性的关键问题。由于在不同文化、传统和地区，尊重、不尊重和暴力的定义可能存在差异，全球对于这些构成要素的操作定义仍缺乏共识。产科暴力是孕期和分娩期间寻求医疗机构护理的一个重大障碍，因此女性可能会选择由非专业人员在家中接生。结果，一些人会出现并发症，从而导致孕产妇死亡率和发病率居高不下。
探讨坦桑尼亚中部地区产后母亲、医疗保健提供者和关键社区信息提供者所感知的产科暴力的背景构成要素。
采用探索性定性案例研究，对24名产后母亲、18名医疗保健提供者和4名宗教领袖进行了有目的的深入访谈。此外，还与男性伴侣、社区卫生工作者和10人小组组长进行了6次焦点小组讨论。数据分析遵循定性内容分析过程，采用归纳法和演绎法。
分析得出了女性在医疗机构护理期间经历的九类产科暴力。这些类别包括缺乏支持性护理和治疗、自主权受限、未经同意的护理、隐私和保密性受损、非循证的痛苦常规程序、言语暴力、性暴力、耻辱和歧视、情感暴力。此外，还出现了与女性在社区层面的经历相关的六类产科暴力。它们包括：强行向阴道内插入草药、言语暴力、身体暴力、心理暴力、强迫在家分娩和不当性行为。
本研究收集的背景构成要素有助于更好地界定坦桑尼亚背景下的产科暴力，并作为参考。这可能有助于验证测量方法，并为制定循证干预措施提供途径，以减少产科暴力并促进尊重孕产妇的护理。
