BackgroundAbuse against women in labor starts with subtle forms of discrimination that can turn into overt violence. Therefore it is crucial to work towards prevention and elimination of disrespect and ill-treatment in medical facility perinatal care in which staff allows such abuse.The aim of the study was to analyze the experiences of women related to perinatal care. Special emphasis was put on experiences that had traits indicating disrespectful and offensive care during childbirth in medical facilities providing perinatal care.MethodsThis was a cross-sectional survey. A questionnaire was prepared for respondents who gave birth in medical facilities. Information about the study was posted on the website of a non-governmental foundation dealing with projects aimed at improving perinatal care. The respondents gave online consent for processing the submitted data. 8378 questionnaires were submitted. The study was carried out between February 06 and March 20, 2018. The results were analyzed using the Chi-square independence test. The analysis was carried out at the significance level of 0.05 in Excel, R and SPSS.ResultsDuring their hospital stay, 81% of women in the study experienced violence or abuse from medical staff on at least one occasion. The most common abuse was having medical procedures without prior consent. Inappropriate comments made by staff related to their own or a woman’s situation were reported in 25% of situations, whilst 20% of women experienced nonchalant treatment. In the study 19.3% of women reported that the staff did not properly care for their intimacy and 1.7% of the respondents said that the worst treatment was related to feeling anonymous in the hospital.ConclusionsThe study shows that during Polish perinatal care women experience disrespectful and abusive care. Most abuse and disrespect involved violation of the right to privacy, the right to information, the right to equal treatment, and the right to freedom from violence. The low awareness of abuses and complaints reported in the study may result from women’s ignorance about relevant laws related to human rights.

The current COVID-19 pandemic put a burden on healthcare services around the globe and impacted many areas of care delivery, including maternity services. Prioritizing ringfenced community care to keep women away from hospitals may be the best strategic response to ensure pregnant and laboring women receive optimal care. By analyzing the structure of maternity services in Poland and their response to the current crisis, we show that while the available model allows to provide large share of prenatal services outside hospital settings, it allows no alternative to hospital births. In addition, medicalization, inequalities in access and fragmentation of care hinder services' ability to respond in a way it ensures best possible care.

Background: Extended breastfeeding is rare in Poland, and lack of acceptance and understanding is often evident in public opinion. The ability to provide reliable information about breastfeeding beyond infancy depends on health professionals’ levels of knowledge and attitudes. They are considered by most parents in Poland to be authorities in the field of child nutrition. Research aims: To determine (1) the level of knowledge and the attitudes of Polish health professionals towards extended breastfeeding; (2) the relationship between personal breastfeeding experience and attitudes towards extended breastfeeding; and (3) the relationship between knowledge about breastfeeding beyond twelve months and attitudes towards breastfeeding beyond infancy. Methods: A one-group prospective, cross-sectional, self-report style survey was used. The convenience sample (N = 495) comprised gynaecologists, neonatologists and midwives. Data were collected via an online questionnaire and the results were analyzed with the use of descriptive statistics, a chi-square independence test, Fisher’s exact test, post-hoc testing, and two-part tables using SPSS. Results: Most of the respondents (76.7%; n = 384) had a low level of knowledge about the benefits of breastfeeding beyond twelve months and even emphasized that this nutritional choice could have negative impacts. There was a positive correlation (F = 105.847; p = < .01) between levels of knowledge and respondents’ attitudes towards breastfeeding beyond infancy. Attitudes were also influenced by the length of time respondents had breastfed. Conclusion: Healthcare providers have an insufficient level of knowledge about extended breastfeeding and need further education in this area.

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<p><span>Od początku lat 90. XX w. nastąpiło wiele zmian w zakresie świadczenia opieki nad kobietą w okresie okołoporodowym oraz nad noworodkiem. Zmiany te są przykładem występującej równolegle do procesu medykalizacji tendencji do demedykalizacji. Celem artykułu jest przedstawienie zmian w zakresie opieki okołoporodowej po transformacji ustrojowej oraz analiza tych przeobrażeń z perspektywy teorii medykalizacji. W pracy staram się scharakteryzować opiekę okołoporodową w Polsce na początku XXI w. w odniesieniu do trzech skutków medykalizacji, tj. rosnącej liczby nieuzasadnionych interwencji medycznych, nieuwzględniania potrzeb rodzących oraz ograniczenia roli położnych. Stawiam tezę, że obserwujemy dwie sprzeczne tendencje. Z jednej strony medykalizacja opieki okołoporodowej jest promowana przez lekarzy, z drugiej demedykalizacja ma swoich zwolenników i zwolenniczki wśród kobiet i położnych. Powstaje zatem pytanie, czy te tendencje wzajemnie się wykluczają czy też stanowią przykład demokratyzacji również w zakresie opieki okołoporodowej, na którą coraz większy wpływ mają aktywne w społeczeństwie obywatelskim różne grupy nacisku.</span></p>

The study aimed to identify the difference in communication needs of women giving birth and women during early postpartum. An additional goal includes the analysis of the experience and communication needs through the context of a woman’s approach to childbirth. The study is a cross-sectional, self-report survey; 521 women between 5 and 10 days after birth participated in the study. Women perceived information provided by the medical staff as the most helpful aspect of verbal communication both during labour and early postpartum. Maintaining eye contact with the medical staff was perceived as the most helpful aspect of non-verbal communication. Women were more satisfied with communication during labour and birth than in the maternity ward and those after non-instrumental childbirth were more satisfied with communication compared to the instrumental birth group. Women perceiving childbirth as the natural, physiological process considered verbal and non-verbal communication during and after childbirth as less helpful than women perceiving birth as more risky and requiring interventions. The results of the study emphasize the importance of verbal and non-verbal communication during birth and early postpartum and at the same time different communication needs during these two time points. It also showed that women who perceive labour as a physiological process seem to be less dependent on the communication with the medical staff than women who accept medical interventions during labour and birth as necessary.

Patient-centered care and the "people first" principle as a tool to prevent stigmatization of patients with obesity

Medicalization of perinatal care in PolandThere has been a lot of changes in the provision of care for women during the perinatal period and newborns since the early 90s past century. These changes are an example occurring in parallel to the process of medicalization and the tendency to demedicalization.The aim of this paper is to analyse these changes from the perspective of the theory of medicalization. In this article we analyse three effects of medicalization: increasing number of unjustified medical interventions, ignoring the needs of childbearing women and reducing the role of midwives.I assert that we observe two contradictory tendencies. On the one hand, the medicalization of perinatal care is promoted by physicians. On the other hand, the demedicalization has its advocates among women and midwives. The question then arises whether these tendencies are exclusive or they are an example of democratization in the field of perinatal care, which are increasingly influenced by active in civil society, various pressure groups.