Research into the abuse of women during childbirth has increased over recent years. Many studies have focussed on labouring women, how they may be physically maltreated, neglected, or shouted at, and on how their needs are unmet by healthcare practitioners. As part of a larger study focussing on staff responses to stillbirths, we wanted to focus our attention on how medical doctors, working in a district hospital in an impoverished urban setting in the Western Cape Province of South Africa, manage, and feel regarding, stillbirths. This healthcare system experiences an immense patient load, with the poverty of the community it serves, and the numerous traumas, affecting both patients and staff. In order to obtain rich exploratory data, a qualitative research methodology was used. The primary data source was interviews with medical doctors regarding their practices with women who have stillbirths. From the interviews, previous findings about this topic are corroborated by our work within the hospital. Additionally, we include and discuss new findings that we discovered in our research, such as frustrations in communication, feeling culturally different, feeling overwhelmed and shame. From our findings we can conclude that dealing with stillbirth is emotionally challenging anywhere in the world, however, in a context like South Africa, there is the added burden of trying to right the wrongs of a brutal and divided society. These medical doctors are dealing not only with stillbirths but also, to a degree, with the stillbirth of the hope that, twenty-five years after becoming a democracy, South Africa is far from becoming a unified and caring society. There is a great irony, of course, in the fact that we see in the data here the re-enactment of dehumanising discourses by the very people who are working very hard to restore humanity in a fractured society. It would be easy simply to condemn these dehumanising, detaching and discriminatory statements and practices. To do so, we believe, would be defensive in itself – for change to occur, we need to understand the complex personal and political roots of what health practitioners do to survive under very difficult circumstances.

中文翻译：

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关怀和羞耻政治：南非地区医院的医生和死产

近年来，对分娩期间虐待妇女的研究有所增加。许多研究都集中在劳动妇女身上，她们可能如何受到身体虐待、忽视或大喊大叫，以及医疗保健从业者如何满足她们的需求。作为一项专注于员工对死产反应的大型研究的一部分，我们希望将注意力集中在在南非西开普省贫困城市环境中的地区医院工作的医生如何管理和感受死产. 这个医疗保健系统承受着巨大的患者负担，它所服务的社区很贫困，而且还有无数创伤，影响着患者和工作人员。为了获得丰富的探索性数据，使用了定性研究方法。主要数据来源是对医生的访谈，了解他们对死产妇女的做法。从采访中，我们在医院内的工作证实了之前关于这个话题的调查结果。此外，我们还包括并讨论了我们在研究中发现的新发现，例如沟通中的挫败感、文化差异感、不知所措和羞耻感。根据我们的研究结果，我们可以得出结论，在世界任何地方处理死产都是一种情感上的挑战，然而，在像南非这样的背景下，试图纠正一个残酷和分裂的社会的错误会带来额外的负担。这些医生不仅处理死产问题，而且在某种程度上处理死产问题，在成为民主国家 25 年后，南非远未成为一个统一和充满爱心的社会。当然，具有极大讽刺意味的是，我们在此处的数据中看到，正是那些在破碎的社会中为恢复人性而努力工作的人们重新制定了非人性化的话语。谴责这些非人性化、超脱和歧视性的言论和做法很容易。我们认为，这样做本身就是防御性的——要发生变化，我们需要了解卫生从业者在非常困难的情况下为生存所做的复杂的个人和政治根源。谴责这些非人性化、超脱和歧视性的言论和做法很容易。我们认为，这样做本身就是防御性的——要发生变化，我们需要了解卫生从业者在非常困难的情况下为生存所做的复杂的个人和政治根源。谴责这些非人性化、超脱和歧视性的言论和做法很容易。我们认为，这样做本身就是防御性的——要发生变化，我们需要了解卫生从业者在非常困难的情况下为生存所做的复杂的个人和政治根源。