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A qualitative study on acceptability of the mistreatment of women during childbirth in Myanmar

机译:缅甸分娩期间妇女虐待的可接受性的定性研究

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Improving the quality of maternal health care is critical to reduce mortality and improve women’s experiences. Mistreatment during childbirth in health facilities can be an important barrier for women when considering facility-based childbirth. Therefore, this study attempted to explore the acceptability of mistreatment during childbirth in Myanmar according to women and healthcare providers, and to understand how gender power relations influence mistreatment during childbirth. A qualitative study was conducted in two townships in Bago Region in September 2015, among women of reproductive age (18–49?years), healthcare providers and facility administrators. Semi-structured discussion guides were used to explore community norms, and experiences and perceptions regarding mistreatment. Coding was conducted using athematic analysis approach and Atlas.ti. Results were interpreted using a gender analysis approach to explore how power dynamics, hierarchies, and gender inequalities influence how women are treated during childbirth. Women and providers were mostly unaccepting of different types of mistreatment. However, some provided justification for slapping and shouting at women as encouragement during labour. Different access to resources, such as financial resources, information about pregnancy and childbirth, and support from family members during labor might impact how women are treated. Furthermore, social norms around pregnancy and childbirth and relationships between healthcare providers and women shape women’s experiences. Both informal and formal rules govern different aspects of a woman’s childbirth care, such as when she is allowed to see her family, whether she is considered “obedient”, and what type of behaviors she is expected to have when interacting with providers. This is the first use of gender analysis to explore how gender dynamics and power relations contribute to women’s experiences of mistreatment during childbirth. Both providers and women expected women to understand and “obey” the rules of the health facility and instructions from providers in order to have better experiences. In this way, deviation from following the rules and instructions puts the providers in a place where perpetrating acts of mistreatment were justifiable under certain conditions. Understanding how gender norms and power structures how women are treated during childbirth is critical to improve women’s experiences.
机译:提高母体保健质量对于减少死亡率并改善妇女的经验至关重要。在考虑基于设施的分娩时,卫生设施中的分娩过程中的虐待可能是妇女的重要障碍。因此,这项研究试图根据妇女和医疗保健提供者探讨缅甸分娩时虐待的可接受性,并了解性别电力关系如何在分娩期间影响虐待。 2015年9月在Bago Region的两座乡镇在生殖年龄(18-49岁以下),医疗保健提供者和设施管理人员中进行了一个定性研究。半结构化讨论指南用于探索社区规范,以及对虐待的经验和看法。使用渴望分析方法和Atlas.ti进行编码。结果是使用性别分析方法解释,探索权力动态,层次和性别不平等如何影响妇女在分娩期间如何治疗。妇女和提供者大多是不可接受的不同类型的虐待。但是,一些在劳动期间为妇女拍打和喊叫的理由。不同的资源获得资源,如财务资源,有关孕妇和分娩的信息,以及在劳动期间的家庭成员的支持可能会影响妇女如何对待。此外,怀孕和分娩周围的社会规范和医疗保健提供者与女性的关系塑造女性经验。非正式和正式的规则都管理女性分娩关怀的不同方面,例如当她被允许看到她的家人时,无论她是否被认为是“服从”,以及在与提供者互动时预计她有什么类型的行为。这是第一次使用性别分析来探讨性别动态和力量如何为妇女在分娩时虐待妇女的经历。供应商和女性预计妇女致力于理解和“遵守”卫生设施规则以及提供商的指示,以获得更好的经验。通过这种方式,偏离规则和指示的偏差将提供者放在某个地方,在某些条件下就是合理的虐待行为。了解性别规范和权力结构如何在分娩期间将妇女治疗如何对改善妇女的经验至关重要。

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