期刊论文详细信息
BMC Pregnancy and Childbirth
Informal coercion during childbirth: risk factors and prevalence estimates from a nationwide survey of women in Switzerland
Stephan Oelhafen1  Eva Cignacco1  Luigi Raio2  Manuel Trachsel3  Settimio Monteverde4 
[1] Department of Health Professions, Applied Research & Development in Midwifery, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland;Department of Obstetrics and Gynecology, University Hospital of Bern, Bern, Switzerland;Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland;Clinical Ethics Unit, University Hospital of Basel and Psychiatric University Clinics Basel, Basel, Switzerland;Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland;Department of Health Professions, School of Nursing, Bern University of Applied Sciences, Bern, Switzerland;
关键词: Coercion;    Informal coercion;    Childbirth;    Switzerland;    Survey;    Mode of delivery;    Mistreatment;    Disrespect;    Abuse;   
DOI  :  10.1186/s12884-021-03826-1
来源: Springer
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【 摘 要 】

BackgroundIn many countries, the increase in facility births is accompanied by a high rate of obstetric interventions. Lower birthrates or elevated risk factors such as women’s higher age at childbirth and an increased need for control and security cannot entirely explain this rise in obstetric interventions. Another possible factor is that women are coerced to agree to interventions, but the prevalence of coercive interventions in Switzerland is unknown.MethodsIn a nationwide cross-sectional online survey, we assessed the prevalence of informal coercion during childbirth, women’s satisfaction with childbirth, and the prevalence of women at risk of postpartum depression. Women aged 18 years or older who had given birth in Switzerland within the previous 12 months were recruited online through Facebook ads or through various offline channels. We used multivariable logistic regression to estimate the risk ratios associated with multiple individual and contextual factors.ResultsIn total, 6054 women completed the questionnaire (a dropout rate of 16.2%). An estimated 26.7% of women experienced some form of informal coercion during childbirth. As compared to vaginal delivery, cesarean section (CS) and instrumental vaginal birth were associated with an increased risk of informal coercion (planned CS risk ratio [RR]: 1.52, 95% confidence interval [1.18,1.96]; unplanned CS RR: 1.92 [1.61,2.28]; emergency CS RR: 2.10 [1.71,2.58]; instrumental vaginal birth RR: 2.17 [1.85,2.55]). Additionally, migrant women (RR: 1.45 [1.26,1.66]) and women for whom a self-determined vaginal birth was more important (RR: 1.15 [1.06,1.24]) more often reported informal coercion. Emergency cesarean section (RR: 1.32 [1.08,1.62]), being transferred to hospital (RR: 1.33 [1.11,1.60]), and experiencing informal coercion (RR: 1.35 [1.19,1.54]) were all associated with a higher risk of postpartum depression. Finally, women who had a non-instrumental vaginal birth reported higher satisfaction with childbirth while women who experienced informal coercion reported lower satisfaction.ConclusionsOne in four women experience informal coercion during childbirth, and this experience is associated with a higher risk of postpartum depression and lower satisfaction with childbirth. To prevent traumatic after-effects, health care professionals should make every effort to prevent informal coercion and to ensure sensitive aftercare for all new mothers.

【 授权许可】

CC BY   

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