The association between disrespect and abuse of women during childbirth and postpartum depression: Findings from the 2015 Pelotas birth cohort study

JOURNAL OF AFFECTIVE DISORDERS

卷:256

Article

Silveira, Mariangela Freitas¹  Mesenburg, Marilia Arndt¹  Bertoldi, Andrea Damaso¹  De Mola, Christian Loret^1,3  Bassani, Diego Garcia⁴  Domingues, Marlos Rodrigues⁵  Stein, Alan⁶  Coll, Carolina V. N.^1,2 

[1] Univ Fed Pelotas, Postgrad Program Epidemiol, Rua Marechal Deodoro 1160,3 Andar, BR-96020220 Pelotas, Brazil

[2] Univ Fed Pelotas, Int Ctr Equ Hlth, Pelotas, Brazil

[3] Fed Univ Rio Grande, Postgrad Program Publ Hlth, Rio Grande, RS, Brazil

[4] Univ Toronto, Hosp Sick Children, Dept Pediat, Ctr Global Child Hlth, 555 Univ Ave, Toronto, ON M5G 1X8, Canada

[5] Univ Fed Pelotas, Postgrad Program Phys Educ, Rua Luiz de Camoes 625, BR-96055630 Pelotas, Brazil

[6] Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford OX3 7JX, England

关键词: Disrespect and abuse;    Childbirth;    Postpartum depression;    Institutional violence;    Gender violence;   

DOI  :  10.1016/j.jad.2019.06.016

来源: Elsevier

【 摘 要 】

Background: This study examined the association between disrespect and abuse of women during facility-based childbirth and postpartum depression (PD) occurrence. Methods: We used data from the 2015 Pelotas (Brazil) Birth Cohort, a population-based cohort of all live births in the city. We assessed 3065 mothers at pregnancy and 3-months after birth. Self-reported disrespect and abuse experiences included physical abuse, verbal abuse, denial of care, and undesired procedures. We estimate the occurrence of each disrespect and abuse type, one or more types and disrespect and abuse score. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess PD. EPDS scores >= 13 and >= 15 indicated at least moderate PD and marked/severe. Odds ratios (OR) were calculated by logistic regression. Results: The prevalence of at least moderate PD and marked/severe PD was 9.4% and 5.7%, respectively. 18% of the women experienced at least one type of disrespect and abuse. Verbal abuse increased the odds of having at least moderate PD (OR = 1.58; 95%CI 1.06-2.33) and marked/severe PD (OR = 1.69; 95%CI 1.06-2.70) and the effect among women who did not experience antenatal depressive symptoms was greater in comparison to those who did (OR = 2.51; 95%CI 1.26-5.04 and OR = 4.27; 95%CI 1.80-10.12). Physical abuse increased the odds of having marked/severe PD (OR = 2.28; 95%CI 1.26-4.12). Having experienced three or more mistreatment types increased the odds of at least moderate PD (OR = 2.90; 95%CI 1.30 - 35.74) and marked/severe PD (OR = 3.86; 95%CI 1.58-9.42). Limitations: Disrespect and abuse experiences during childbirth were self-reported. Conclusions: Disrespect and abuse during childbirth increased the odds of PD three months after birth. Strategies to promote high quality and respectful maternal health care are needed to prevent mother-child adverse outcomes.

【 授权许可】

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