在英格兰,种族与出生地之间的关系:一种混合方法研究
Frances Rivers1, Christopher Grollman2, Zahra Khan2
1Kingston Hospital NHS Foundation Trust, Galsworthy Road, Kingston Upon Thames, KT2 7QB, England. frances.rivers@nhs.net.
BMC pregnancy and childbirth
|November 28, 2024
概括
在出生地选择方面存在种族差异,南亚女性不太可能使用助产士领导的设置. 文化规范和助产士有限的信息共享可能会导致这些不平等.
科学领域:
- 孕产妇健康 孕产妇健康
- 健康差异 在健康上的差异
- 种族和医疗保健 获取 获取
背景情况:
- 英国的产妇政策提供了分娩选择:产科主导单位 (OU),助产士主导单位 (MLU) 或家庭分娩.
- 少数民族妇女面临着严重的健康差异和不公平的护理,但出生地选择在种族视角下未得到充分研究.
- 大多数分娩都发生在产科主导的单位中,尽管有证据支持助产士主导的设置对不复杂的怀孕.
研究的目的:
- 在一个城市的英国NHS信托中调查种族和出生地之间的关联.
- 为了确定不同种族群体在出生地选择中的差异.
- 探索来自少数民族背景的妇女在出生地决定方面的经验.
主要方法:
- 一个混合方法的顺序解释性研究设计.
- 来自伦敦NHS信托基金会的2014-2023年出生数据的定量分析,不包括计划的剖腹产,早产和多胎.
- 对10名南亚妇女关于她们出生地经历的半结构面试进行了定性主题分析.
主要成果:
- 白人女性使用助产士主导的设置比其他种族更频繁 (27.5%),包括南亚女性 (20.6%).
- 南亚妇女在家庭分娩的数量显著减少 (0.8%,而白人女性为2.7%),并且在助产士领导的环境中分娩的可能性更低,即使经过对主要的人口和临床因素的调整 (aOR 0.61).
- 定性调查结果显示,医院为主,医生领导的分娩假设;助产士领导的环境被认为是安全的,但对一些人来说在文化上是非常规的.
结论:
- 在出生地选择方面,仍然存在显著的种族差异.
- 文化因素和潜在的障碍,如助产士有限的信息共享,可能会不成比例地影响少数民族妇女进入助产士领导的分娩环境.
- 个性化信息和改善助产士领导的选项的获取对于减少健康不平等和促进最佳孕产妇健康至关重要.
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