在澳大利亚的产妇环境中,妇女经历的创伤性阴道分娩

A. Yates, L. Jones, Merv Jackson
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引用次数: 1

摘要

目的:在20世纪50年代澳大利亚开始医疗化之前,分娩是妇女的唯一领域。当代生育实践给女性带来了更加医疗化的技术环境,结果好坏参半。在最近的调查中,45.5%的澳大利亚妇女报告说她们经历过分娩创伤;近20%的人患有产后抑郁症。虽然有一些关于经历剖腹产的女性创伤的研究,但对与正常阴道分娩相关的感知创伤经历的研究很少。方法:本研究采用定性方法,探讨创伤性正常分娩对产妇心理和情绪的影响。本研究采用深度半结构化访谈,并在现象学范式内分析数据。数据分析揭示了九个主题:我决心自然分娩;不告诉我他们在做什么;我只需要强迫她出生;这真的很可怕;我知道这就是体制的样子……她们是医院的助产士…他们医疗;我觉得和他们没有联系;她为我挺身而出;出生后,只是恐怖;我应该有一个更好的出生。结果:虽然比率尚不清楚,但这些发现强调了一些妇女在正常阴道分娩的经历中遭受创伤。被认为的原因包括:助产士不总是与妇女在一起并支持生理分娩;妇女没有充分了解情况;产房内的权力不对称与霸权一种以胎儿为中心的护理模式,让女性感到不受尊重、被剥夺了权力、被物化了。结论:研究结果表明,助产士需要真正地与妇女在一起,提供持续的护理,并支持分娩的生理过程,对分娩后创伤意识的医疗和助产专业教育,重新思考产前教育计划,包括应对策略和在医院产后住院时提供更多的助产支持。
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Women’s experiences of perceived traumatic vaginal birth in Australian maternity settings
Objective: Before the beginning of medicalisation in Australia during the 1950s, childbirth was the sole domain of women. Contemporary birthing practices have posed a more medicalised technological environment on women resulting in both good and bad outcomes. In recent surveys, 45.5% of Australian women reported experiencing birth as traumatic; with nearly 20% experiencing postnatal depression. While there have been some studies on women’s trauma experiencing a caesarean section, minimal research has been completed into perceived traumatic experiences related to normal vaginal births.Methods: This study utilized a qualitative methodology to explore psychological and emotional impact of women’s experiences with perceived traumatic normal births. The research used an in-depth semi-structured interview and analysed the data within the phenomenological paradigm. The data analysis revealed nine themes: I was determined to birth naturally; Not telling me what they were doing; I just had to force her to be born; it was really horrific; I know that is just what the system is like. . . they’re hospital midwives. . . they’re medical; I didn’t feel connected to them; She stood up for me; After the birth, just horrible; I deserve a better birth.Results: Although the rates are unclear, these findings highlight that some women suffer trauma from their experience of a normal vaginal birth. The perceived causes include: midwives not always being with women and supporting physiological childbirth; women not being fully informed; power asymmetries and hegemony inside the birthing room; and a fetocentric model of care that left women feeling disrespected, disempowered and objectified.Conclusions: The findings indicate a need for midwives to truly be with women and provide continuity of care, as well as supporting the physiological process of childbirth, medical and midwifery professional education on trauma awareness following birth, a rethinking of antenatal education programs to include coping strategies and greater midwifery support in the hospital post-natal stay.
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