“Is the doctor God to punish me?!” An intersectional examination of disrespectful and abusive care during childbirth against single mothers in Tunisia

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Title: “Is the doctor God to punish me?!” An intersectional examination of disrespectful and abusive care during childbirth against single mothers in Tunisia
Authors: Amroussia, Nada | Hernández, Alison | Vives-Cases, Carmen | Goicolea, Isabel
Research Group/s: Salud Pública | Investigación en Género (IG)
Center, Department or Service: Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia | Universidad de Alicante. Instituto Universitario de Investigación de Estudios de Género
Keywords: Tunisia | Childbirth | Single mothers | Maternal health | Abusive care | Disrespectful care | Intersectionality | Qualitative thematic analysis
Knowledge Area: Medicina Preventiva y Salud Pública
Issue Date: 4-Mar-2017
Publisher: BioMed Central
Citation: Reproductive Health. 2017, 14:32. doi:10.1186/s12978-017-0290-9
Abstract: Background: Disrespectful and abusive treatment during childbirth is a violation of women’s right to dignified, respectful healthcare throughout pregnancy and childbirth. Although reports point out that marginalized groups in society such as single mothers are particularly vulnerable to abusive and disrespectful care, there is a lack of in-depth research exploring single mothers’ encounters at the maternal healthcare facilities, especially in Tunisia. In Tunisia, single mothers are particularly vulnerable due to their social stigmatization and socio-economic marginalization. This study examines the self-perceptions and childbirth experiences of single mothers at the public healthcare facilities in Tunisia. Methods: This study follows a qualitative design. Eleven single mothers were interviewed in regard to their experiences with maternal healthcare services and their perceptions of the attitudes of the health workers towards them. The interviews also addressed the barriers faced by the participants in accessing adequate maternal healthcare services, and their self-perceptions as single mothers. The data were analyzed using an inductive thematic approach guided by the feminist intersectional approach. Emergent codes were grouped into three final themes. Results: Three themes emerged during the data analysis: 1) Experiencing disrespect and abuse, 2) Perceptions of regret and shame attributed to being a single mother, and 3) The triad of vulnerability: stigma, social challenges, and health system challenges. The study highlights that the childbirth experiences of single mothers are shaped by intersectional factors that go beyond the health system. Gender plays a major role in constructing these experiences while intersecting with other social structures. The participants had experienced disrespectful and discriminatory practices and even violence when they sought maternal healthcare services at the public healthcare facilities in Tunisia. Those experiences reflect not only the poor quality of maternal health services but also how health system practices translate the stigma culturally associated with single motherhood in this setting. Social stigma did not only affect how single mothers were treated during the childbirth, but also how they perceived themselves and how they perceived their care. Conclusion: Ensuring women’s right to dignified, respectful healthcare during childbirth requires tackling the underlying causes of social inequalities leading to women’s marginalization and discrimination.
URI: http://hdl.handle.net/10045/66909
ISSN: 1742-4755 | 10.1186/s12978-017-0290-9
Language: eng
Type: info:eu-repo/semantics/article
Rights: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Peer Review: si
Publisher version: http://dx.doi.org/10.1186/s12978-017-0290-9
Appears in Collections:INV - SP - Artículos de Revistas
INV - Investigación en Género - Artículos de Revistas
Institucional - IUIEG - Publicaciones

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