Aufklärung und Indikation zur Sectio als Beispiel für geburtshilflichen Paternalismus versus Geburtsmedizin als Dienstleistung für autonome Gebärende

Uphoff, Roland

doi:10.1007/978-3-642-18434-5_22

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…For example, in a Canadian survey of 6421 women, 79.8% said they were satisfied with their overall birth experience, even though the rate of obstetric interventions was high [ 11 ]. In most regions of the world, the average fertility rate has declined by more than 50% over the last hundred years, which may explain the increased emphasis on safety and control during pregnancy and childbirth [ 7 , 12 ]. Some women actually favor interventions for a quicker and ideally painless childbirth rather than a vaginal birth with no intervention [ 2 ], especially if they feel anxious about giving birth or have had previous negative experiences [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Informal coercion during childbirth: risk factors and prevalence estimates from a nationwide survey of women in Switzerland

Oelhafen

Trachsel

Monteverde

et al. 2021

BMC Pregnancy Childbirth

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Background In many countries, the increase in facility births is accompanied by a high rate of obstetric interventions. Lower birthrates or elevated risk factors such as women’s higher age at childbirth and an increased need for control and security cannot entirely explain this rise in obstetric interventions. Another possible factor is that women are coerced to agree to interventions, but the prevalence of coercive interventions in Switzerland is unknown. Methods In a nationwide cross-sectional online survey, we assessed the prevalence of informal coercion during childbirth, women’s satisfaction with childbirth, and the prevalence of women at risk of postpartum depression. Women aged 18 years or older who had given birth in Switzerland within the previous 12 months were recruited online through Facebook ads or through various offline channels. We used multivariable logistic regression to estimate the risk ratios associated with multiple individual and contextual factors. Results In total, 6054 women completed the questionnaire (a dropout rate of 16.2%). An estimated 26.7% of women experienced some form of informal coercion during childbirth. As compared to vaginal delivery, cesarean section (CS) and instrumental vaginal birth were associated with an increased risk of informal coercion (planned CS risk ratio [RR]: 1.52, 95% confidence interval [1.18,1.96]; unplanned CS RR: 1.92 [1.61,2.28]; emergency CS RR: 2.10 [1.71,2.58]; instrumental vaginal birth RR: 2.17 [1.85,2.55]). Additionally, migrant women (RR: 1.45 [1.26,1.66]) and women for whom a self-determined vaginal birth was more important (RR: 1.15 [1.06,1.24]) more often reported informal coercion. Emergency cesarean section (RR: 1.32 [1.08,1.62]), being transferred to hospital (RR: 1.33 [1.11,1.60]), and experiencing informal coercion (RR: 1.35 [1.19,1.54]) were all associated with a higher risk of postpartum depression. Finally, women who had a non-instrumental vaginal birth reported higher satisfaction with childbirth while women who experienced informal coercion reported lower satisfaction. Conclusions One in four women experience informal coercion during childbirth, and this experience is associated with a higher risk of postpartum depression and lower satisfaction with childbirth. To prevent traumatic after-effects, health care professionals should make every effort to prevent informal coercion and to ensure sensitive aftercare for all new mothers.

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Section: Introductionmentioning

confidence: 99%

Informal coercion during childbirth: risk factors and prevalence estimates from a nationwide survey of women in Switzerland

Oelhafen

Trachsel

Monteverde

et al. 2021

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

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“…Entscheidungskompetenz des Arztes, 3. Entscheidungszuständigkeit bei kompetenter Entscheidungsautonomie der Gebärenden" [6].…”

Section: Zeitpunkt Der Aufklärungspflichtunclassified

Rechtskonformität der ärztlichen Aufklärung bei relativ indizierter sekundärer Sectio an geburtshilflichen Kliniken in Deutschland – Teil I: Status quo-Erhebung

Jaster,

Gaidzik,

Schiermeier

2023

Z Geburtshilfe Neonatol

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Zusammenfassung Einleitung Zur Wahrung des Selbstbestimmungsrechts der Patientin erwartet die höchstrichterliche Rechtsprechung im Falle der relativen Indikation zur sekundären Sectio eine vorgezogene Aufklärung über diese echte Behandlungsalternative sowie die Möglichkeit der Wahlentscheidung für den Geburtsmodus seitens der Patientin. Das Ziel dieser deutschlandweiten Studie war die Erhebung des Status quo zur Rechtskonformität der diesbezüglichen Aufklärungspraxis an allen deutschen geburtshilflichen Kliniken sowie ein darauf aufbauender Vergleich anhand des Klinikformats. Methodik Alle geburtshilflichen Kliniken in Deutschland wurden im Rahmen einer anonymen Online-Studie mit einem auf der Basis des BGH-Urteils vom 28.08.2018 (AZ: VI ZR 509/17) entwickelten Fragebogen per E-Mail angeschrieben. Drei Fragen mussten zur Bejahung der Rechtskonformität kumulativ mit „ja“ beantwortet werden. Die antwortenden Kliniken wurden anhand ihres Formates (Status als Universitätsklinikum / Andere Kliniken geschichtet nach Anzahl der Geburten pro Jahr) in sechs Gruppen eingeteilt. Ergebnisse 93 Fragebögen konnten ausgewertet werden. 14 Kliniken (15,05%) erfüllen die Anforderungen. Kliniken mit einer jährlichen Geburtenzahl von 1.000–1.499 schneiden im Vergleich noch am besten ab. Schlussfolgerung Es besteht der dringende Bedarf nach einem sicheren rechtskonformen Aufklärungskonzept für die alltägliche Geburtspraxis an deutschen Kliniken.

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Informal coercion during childbirth: risk factors and prevalence estimates from a nationwide survey among women in Switzerland

Oelhafen

Trachsel

Monteverde

et al. 2020

Preprint

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Background In many countries, the increase in facility births is accompanied by a high rate of obstetric interventions. Lower birthrates or elevated risk factors such as women's higher age at childbirth and thus a higher need for control and security cannot entirely explain this rise in obstetric interventions. Another potential factor is that women feel coerced to agree to interventions; however, the prevalence of coercive interventions is unknown. Methods In a nationwide cross-sectional online survey, we assessed mothers' satisfaction with childbirth and the prevalence of informal coercion during childbirth and of women at risk for postpartum depression. We used multivariable logistic regression to estimate the risk associated with multiple individual and contextual factors. Women at least 18 years old who gave birth in Switzerland within the previous 12 months were recruited online via Facebook ads or offline via various channels. Results A total of 6'054 women completed the questionnaire (drop-out rate 16.2%). An estimated 26.7% experience some form of informal coercion during childbirth. Having a cesarean section or instrumental vaginal birth was associated with an increased risk to experience informal coercion (all risk ratios > 1.5). The risk was also increased for women with a migrant background, women living in more urban regions and women with a risk pregnancy. Also, women to whom having a self-determined vaginal birth is important reported on informal coercion more often. Being at risk for postpartum depression was mostly associated with having an emergency cesarean section, having been transferred to hospital and the experience of informal coercion. Also, women with a migrant background seem to be at a higher risk to develop postpartum depression or having other mental health issues. Finally, women who had a non-instrumental vaginal birth reported higher satisfaction with childbirth experience and women who experienced informal coercion reported lower satisfaction. Conclusions One in four women experience informal coercion during childbirth, and this experience is associated with being at risk for postpartum depression and lower satisfaction with childbirth. Health care professionals should make every effort to prevent informal coercion and ensure sensitive aftercare for all new mothers in order to prevent traumatic effects.

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Aufklärung und Indikation zur Sectio als Beispiel für geburtshilflichen Paternalismus versus Geburtsmedizin als Dienstleistung für autonome Gebärende

Cited by 3 publications

References 9 publications

Informal coercion during childbirth: risk factors and prevalence estimates from a nationwide survey of women in Switzerland

Informal coercion during childbirth: risk factors and prevalence estimates from a nationwide survey of women in Switzerland

Rechtskonformität der ärztlichen Aufklärung bei relativ indizierter sekundärer Sectio an geburtshilflichen Kliniken in Deutschland – Teil I: Status quo-Erhebung

Informal coercion during childbirth: risk factors and prevalence estimates from a nationwide survey among women in Switzerland

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