Women's Views of Women: Young Women's Sexual and Reproductive Health Stigmatization Tendencies

Yıl 2025, Cilt: 15 Sayı: 1, 305 - 313, 31.01.2025

Elif Dağlı , Feyza Aktaş Reyhan

https://doi.org/10.31020/mutftd.1514546

Öz

Aim: The aim of the study is to determine the Sexual Health/Reproductive Health (SH/RH) stigmatization tendencies of young women and related factors.
Method: The study was conducted between April 3 and July 28, 2023. It is a cross-sectional and descriptive study. The population of the study consisted of 327 women who applied to the Obstetrics and Gynecology Polyclinic of a training and research hospital, and 232 women constituted the sample. The data were collected by face-to-face interview method in the waiting room of the outpatient clinic. Data were collected using the Young Women's Sexual/Reproductive Health Stigma Scale (YWSRHSS).
Results: According to the YWSRHSS, it was determined that the stigmatizing attitudes of the young women participating in the study were above the moderate level (13.42±6.35). A significant difference was found between the mean scores of the YWSRHSS according to the women's socio-demographic variables of education (p=,000), employment status (p=,004) and relationship status (p=,002) (p<.05). In addition, a significant difference was found between the mean YWSRHSS scores and the obstetric characteristics of pregnancy (p=,002), birth (p=,016), abortion (p=,001), and family planning (p=,000) (p<.05).
Conclusion: In this study, it was determined that young women supported stigmatizing attitudes towards SH/RH and observed/felt SH/RH stigma in their environment. Changing women's attitudes about stigma should be one of the priorities of public health workers in combating stigma. It is recommended that public health professionals provide qualified, youth-friendly and school-integrated SH/RH training to adolescents/young people.

Anahtar Kelimeler

Sexual health, Stigma, Women, Reproductive health

Kadının Kadına Bakışı: Genç Kadınların Cinsel Sağlık ve Üreme Sağlığı Damgalama Eğilimleri

Öz

Amaç: Çalışmanın amacı, genç kadınların Cinsel Sağlık/Üreme Sağlığı (CS/ÜS) damgalama eğilimlerini ve ilişkili faktörleri belirlemektir.
Yöntem: Çalışma 3 nisan-28 temmuz 2023 tarihleri arasında gerçekleştirilmiştir. Kesitsel ve tanımlayıcı türde bir çalışmadır. Araştırmanın evrenini bir devlet hastanesinin Kadın Hastalıkları ve Doğum Polikliniğine başvuru yapan 3270 kadın, örneklemini ise 232 kadın oluşturmuştur. Veriler, poliklinik bekleme salonunda yüz yüze görüşme yöntemi ile toplanmıştır. Genç Kadınların Cinsel/Üreme Sağlığı Damgalama Ölçeği (GKCÜSDÖ) ile veriler toplandı.
Bulgular: GKCÜSDÖ göre, çalışmaya katılan genç kadınların damgalama tutumları orta düzeyin üzerinde (13,42±6,35) olduğu tespit edilmiştir. Kadınların sosyo-demografik değişkenlerinden eğitim durumu (p=,000), çalışma durumu (p=,004) ve ilişki durumuna (p=,002) göre GKCÜSDÖ puan ortalamaları arasında anlamlı fark elde edilmiştir (p<,05). Yanısıra obstetrik özelliklerden gebelik (p=,002), doğum (p=,016), kürtaj (p=,001), aile planlaması (p=,000) değişkenleri ile GKCÜSDÖ puan ortalamaları arasında anlamlı fark elde edilmiştir (p<,05).
Sonuç: Bu araştırmada, çaçalışmaya katılan genç kadınların CS/ÜS’e yönelik damgalayıcı tutumları destekledikleri, çevrelerinde CS/ÜS damgasını gözlemledikleri/hissettikleri belirlenmiştir. Damgalamayla ilgili kadınların tutumlarının değiştirilmesi, damgalamayla mücadelede halk sağlığı çalışanların önceliklerden biri olmalıdır. Halk sağlığı çalışanların, adölesan/gençlerin CS/ÜS konularında nitelikli, genç dostu ve okula entegre CS/ÜS eğitimleri vermeleri önerilir.

Anahtar Kelimeler

Cinsel sağlık, Damgalama, Kadın, Üreme sağlığı

Kaynakça

• 1. White-Hughto JM, Reisner SL, Pachankis JE. Transgender stigma and health: a critical review of stigma determinants, mechanisms, and interventions. Soc Sci Med 2015;147:222-31.
• 2. Mohammadi F, et al. The stigma of reproductive health services utilization by unmarried women. Iran J Red Crescent Med 2016;18:e24231.
• 3. Bakır N, Irmak-Vural P, Demir C. Genç kadınların perspektifinden cinsel sağlık ve üreme sağlığında damgalama. Androl Bul 2021;23:146-151.
• 4. Bohren MA, et al. Strategies to reduce stigma and discrimination in sexual and reproductive healthcare settings: A mixed-methods systematic review. PLOS Global Public Health 2022;2(6):e0000582. doi: 10.1371/journal.pgph.00 00582.
• 5. Khosla R, et al. International human rights and the mistreatment of women during childbirth. Health and Human Rights 2016;18(2):131-43.
• 6. Zampa C, et al. Operationalizing a human rights-based approach to address mistreatment against women during childbirth. Health and Human Rights 2020;22(1):251-64.
• 7. Cook RJ, Dickens BM. Reducing stigma in reproductive health. Int jgynaecology and Obstetrics 2014;125(1):89-92.
• 8. Mohamed D, Diamond-Smith N, Njunguru J. Stigma and agency: Exploring young kenyan women’s experiences with abortion stigma and ındividual agency. Reprod Health Matters 2018;26(52):1492285.
• 9. Bayrakçeken E. Genç kadınlarda cinsel ve üreme sağlığı damgalama ölçeği geçerlik ve güvenirliği. Atatürk Üniversitesi Sağlik Bilimleri Enstitüsü. Doğum, Kadın Sağlığı ve Hastalıkları Hemşireliği Ana Bilim Dalı Yüksek Lisans Tezi. Erzurum. 2018.
• 10. Chandra-Mouli V, et al. Contraception for adolescents in low and middle ıncome countries: Needs, barriers, and access. Reprod Health 2014;11(1):1
• 11. Blanc AK, et al. Patterns and trends in adolescents' contraceptive use and discontinuation in developing countries and comparisons with adult women. Int Perspect Sex Reprod Health 2009;35(2):63-71.
• 12. Oğul Z. Adölesan ve gençlerde cinsel sağlık üreme sağlığı: Etkileyen faktörler ve sorunlar. Kadın Sağlığı Hemşireliği Dergisi 2021;7(2):149-165.
• 13. Sudhinaraset M, et al. Women’s status and experiences of mistreatment during childbirth in uttar pradesh: A mixed methods study using cultural health capital theory. BMC Pregnancy And Childbirth 2016;16(1):332.
• 14. Afulani PA, Sayi TS, Montagu D. Predictors of person-centered maternity care: The role of socioeconomic status, empowerment, and facility type. BMC Health Services Research 2018;18(1):360.
• 15. Afulani PA, et al. Person-centred maternity care in low-ıncome and middle-ıncome countries: analysis of data from Kenya, Ghana, and India. The Lancet Global Health 2019;7(1):e96-e109.
• 16. Irinyenikan TA, et al. Adolescent experiences of mistreatment during childbirth in health facilities: secondary analysis of a community-based survey in four countries. BMJ Global Health 2022;5(2):e007954. doi:10.1371/journal.pone 0195163.
• 17. Steinberg JR, et al. Psychosocial factors and preabortion psychological health: The significance of stigma. Soc Sci Med 2016;150:67-75.
• 18. Hanschmidt F, et al. Stigma in the context of pregnancy termination after diagnosis of fetal anomaly: Associations with grief, trauma, and depression. Arch Womens Ment Health 2018;21(4):391-9.
• 19. Gelman A, et al. Abortion stigma among low-income women obtaining abortions in western pennsylvania: A qualitative assessment. Perspect Sex Reprod Health 2017;49(1):29-36.
• 20. Nmadu AG, Mohamed S, Usman NO. Adolescents’ utilization of reproductive health services in Kaduna, Nigeria: The role of stigma. Vulnerable Children and Youth Studies 2020;15(3);246-256. doi:10.1080/ 1745012 8.2020.1800156.
• 21. Hall KS, et al. Factors associated with sexual and reproductive health stigma among adolescent girls in Ghana. PLoS One 2018;2;13(4):e0195163.
• 22. Hall KS, et al. Development and validation of a scale to measure adolescent sexual and reproductive health stigma: Results from young women in Ghana. J Sex Res 2018;55:60-72.
• 23. Yaman E, Güngör H. Damgalama eğilimine ilişkin öğretmen görüşleri. Adıyaman Üniversitesi Sosyal Bilimler Enstitüsü Dergisi 2014;7(18):823-851.
• 24. Shodimu MA, et al. Determinants of perceived stigmatizing and discriminating attitudes towards people living with HIV/AIDS among women of reproductive age in Nigeria. Journal of AIDS and HIV Research 2017;9(6):139-151.
• 25. Kelly DM. Stigma stories: Four discourses about teen mothers, welfare, and poverty. Youth Soc 1996;27(4):421-449.
• 26. Van Brakel WH. Measuring health-related stigma-A literature review. Psychol Health Med 2006;11:307-334.
• 27. Hatzenbuehler ML, Phelan JC, Link BG. Stigma as fundamental cause of population health inequalities. Am J Pub Health 2013;103:813-821.
• 28. Hall KS, et al. Social discrimination, mental health, and risk of unintended pregnancy among young women. J Adolesc Health 2015;56(3):330-337. pmid:25586228
• 29. Yardley E. Teenage mothers’ experiences of stigma. Journal of Youth Studies 2008;11(6):671-84. doi:10.1080/13676260802392940.
• 30. McDermott E. Graham H. Resilient Young mothering: Social inequalities, late modernity and the ‘problem’ of teenage motherhood. Journal of Youth Studies 2005;8(1):59-79.
• 31. Wienmann CM, et al. Are pregnant adolescents stigmatized by pregnancy? J Adolesc Health 2005;36:1-7. doi:10.1016/j.jadohealth.2004.06.006.
• 32. Yılmaz B, Şahin N. Kürtaj ve damgalanma: Bir sistematik derleme. Türkiye Klinikleri J Med Ethics 2020;28:451-62.
• 33. Kebede MT, Middelthon AL, Hilden PK. Negotiating the social and medical dangers of abortion on addis ababa: an exploration of young, unmarried women's abortion-seeking journeys. Health Care Women Int 2018;39(2):186-207.
• 34. Atuyambe L, et al. Faxelid E. Experiences of pregnant adolescents-voices from Wakiso District, Uganda. African Health Sciences 2005;5(4):304-309. doi:10.5555/afhs.2005.5.4.304.
• 35. Levandowski BA, et al. Investigating social consequences of unwanted pregnancy and unsafe abortion in Malawi: The role of stigma. Int J Gynecol Obstet 2012;118(2):167-171. doi:10.1016/S0020-7292(12)60017-4.
• 36. Shellenberg KM. Abortion stigma in the United States: quantitative and qualitative perspectives from women seeking an abortion. The Johns Hopkins University. 2010.
• 37. Major B, Gramzow RH. Abortion as stigma: cognitive and emotional implications of concealment. Journal of personality and social psychology 1999;77(4):735.
• 38. Morris JL, Rushwan H. Adolescent sexual and reproductive health: The Global challenges. International Journal of Gynecology and Obstetrics 2015;131:40-42.
• 39. Gyan SE. Passing as “normal”: Adolescent girls’ strategies for escaping stigma of premarital sex and childbearing in Ghana. Sage Open 2018;8(3):2158244018801421.
• 40. Hanschmidt F, et al. Abortion stigma: a systematic review. Perspectives on sexual and reproductive health 2016;48(4):169-177.