Doğumda Mahremiyet ve Gizliliğin Önemi
Özet
Doğumda mahremiyet ve gizliliğin korunması, kadınların onuruna saygı gösteren, güvenli ve olumlu doğum deneyimlerinin temel bileşenidir. Mahremiyet; bireyin bedenine, duygularına, düşüncelerine ve kişisel bilgilerine yönelik sınırlarını belirleme hakkı olarak tanımlanırken, gizlilik, bu bilgilerin korunması ve paylaşımında etik ve yasal sorumlulukları içerir. Bu bölümde, doğum sürecinde mahremiyetin fiziksel, psikolojik, sosyal ve bilgi boyutları ele alınmış; mahremiyetin ihlalinin kadınların doğum deneyimi, özyeterlilik ve bağlanma süreçleri üzerindeki olumsuz etkileri tartışılmıştır. Dünya Sağlık Örgütü, NICE ve ACOG rehberleri doğrultusunda, mahremiyetin saygılı doğum bakımının ayrılmaz bir parçası olduğu vurgulanmıştır. Ebelik uygulamalarında savunuculuk, iletişim becerileri, özerklik desteği ve güven temelli ilişkiler, mahremiyetin korunmasında kilit unsurlar olarak sunulmuştur. Mahremiyetin sağlanması, yalnızca bireysel bir hak değil, aynı zamanda kadın merkezli bakımın, etik eylemin ve insan onuruna dayalı sağlık hizmetlerinin göstergesidir.
Preserving privacy and confidentiality during childbirth is a cornerstone of respectful, safe, and positive birth experiences that uphold women’s dignity. Privacy is defined as the individual’s right to control access to her body, emotions, thoughts, and personal information, while confidentiality refers to the ethical and legal responsibilities of protecting that information. This chapter discusses the physical, psychological, social, and informational dimensions of privacy during childbirth and explores the negative consequences of its violation on women’s birth experience, self-efficacy, and bonding processes. In line with WHO, NICE, and ACOG guidelines, privacy is emphasized as an integral component of respectful maternity care. Advocacy, effective communication, autonomy support, and trust-based relationships are identified as essential elements in midwifery practice to ensure privacy. Maintaining privacy is not merely an individual right but a reflection of woman-centered care, ethical action, and human dignity in healthcare.
Referanslar
Hathaliya JJ, Tanwar S. An exhaustive survey on security and privacy issues in healthcare 4.0. Computer Communications. 2020; 153(1):311-335. https://doi.org/10.1016/j.comcom.2020.02.018
Price WN, Cohen IG. Privacy in the age of medical big data. Nature Medicine. 2019; 25(1):37-43. doi: 10.1038/s41591-018-0272-7.
Akyüz E, Erdemir F. Surgical patients’ and nurses’ opinions and expectations about privacy in care. Nursing Ethics. 2013; 20(6):660-671. doi: 10.1177/0969733012468931.
Aksoy S, Komurcu N. Privacy in perinatal services: A qualitative study. IOSR Journal of Nursing and Health Science. 2018; 7(5):64-73. doi: 10.9790/1959-0705116473.
World Health Organization. WHO Recommendations on Intrapartum Care for A Positive Childbirth Experience. 2018.
National Institute for Health and Care Excellence. Intrapartum Care (NICE Guideline NG235). [Online] https://www.nice.org.uk/guidance/ng235 [Accessed: 3rd November 2025].
American College of Obstetricians & Gynecologists. Opinion, number 819. Informed consent and shared decision making in obstetrics and gynecology. Obstet Gynecol. 2021; 137:e34-e41.
Ersoy N, Özcan M, Ergin A. Ebelik uygulamalarında profesyonel etik. Ankara: Nobel Akademik Yayıncılık; 2015.
Durgun SK, Şen S, Tayhan E. Ulusal ve uluslararasi ebelik etik kodları. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi. 2018; 5:127-223.
Bajrić S. Data security and privacy issues in healthcare. Applied Medical Informatics. 2020; 42(1):19-27.
Hasan Tehrani T, Seyed Bagher Maddah S, Fallahi-Khoshknab M, Mohammadi Shahboulaghi F, Ebadi A. Perception hospitalized patients from respect for privacy. Iranian Journal of Nursing Research. 2018; 13(1):80-87.
Valizadeh F, Heshmat F, Motaghi Z. The parturient women’s privacy preservation in the delivery rooms: A qualitative study. Journal of Caring Sciences. 2022; 18;12(1):33-41. doi: 10.34172/jcs.2023.30401.
Sağlık Bakanlığı. Hasta Hakları Yönetmeliği. (1998). (26/01/2026 tarihinde https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=4847&MevzuatTur=7&MevzuatTertip=5 adresinden ulaşılmıştır).
Yürümez Y, Çevik T, Yavuz Y. Hasta haklarını biliyor muyuz? Akademik Acil Tıp Dergisi. 2010; 9(2):67-71.
Bekmezci H, Özkan H. Ebelik uygulamalarında mahremiyetin önemi. Sağlık Bilimleri ve Meslekleri Dergisi. 2015; 2(1):113-124.
Leino‐Kilpi H, Välimäki M, Dassen T, Gasull M, Lemonidou C, Scott PA, Arndt M, Kaljonen A. Maintaining privacy on post‐natal wards: A study in five European countries. Journal of Advanced Nursing. 2002; 37(2):145-154. doi: 10.1046/j.1365-2648.2002.02070.x.
Rados M, Kovács E, Mészáros J. Intimacy and privacy during childbirth. A pilot-study testing a new self-developed questionnaire: The Childbirth Intimacy and Privacy Scale (CIPS). Regional Studies on Health Science. 2015; 19(1):16-24. doi: 10.5604/14270994.1155328
Bulto GA, Demissie DB, Tulu AS. Respectful maternity care during labor and childbirth and associated factors among women who gave birth at health institutions in the West Shewa zone, Oromia region, Central Ethiopia. BMC Pregnancy and Childbirth. 2020; 20:443. https://doi.org/10.1186/s12884-020-03135-z
Dzomeku VM, Mensah ABB, Nakua EK, Agbadi P, Okyere J, Donkor P, Lori JR. Promoting respectful maternity care: challenges and prospects from the perspectives of midwives at a tertiary health facility in Ghana. BMC Pregnancy and Childbirth. 2022; 22:451. https://doi.org/10.1186/s12884-022-04786-w
19. Asefa A. Unveiling respectful maternity care as a way to address global inequities in maternal health. BMJ Global Health. 2021; 6(1):e003559. doi: 10.1136/bmjgh-2020-003559.
Jenkinson B, Josey N, Kruske S. BirthSpace: An Evidence-Based Guide to Birth Environment Design. Brisbane, QLD, Australia: Queensland Centre for Mothers & Babies, The University of Queensland. 2014.
Shin JH, Maxwell LE, Eshelman P. Hospital birthing room design: A study of mothers’ perception of hominess. Journal of Interior Design. 2004; 30(1):23-36. https://doi.org/10.1111/j.1939-1668.2004.tb00397.x
Odent M. Birth and Breastfeeding: Rediscovering the Needs of Women during Pregnancy and Childbirth. Clairview Books; 2007.
Foureur M, Davis D, Fenwick J, Leap N, Iedema R, Forbes I, Homer CSE. The relationship between birth unit design and safe, satisfying birth: Developing a hypothetical model. Midwifery. 2010; 26(5):520-525. doi: 10.1016/j.midw.2010.05.015.
Lothian JA. Do not disturb: The importance of privacy in labor. The Journal of Perinatal Education. 2004; 13(3):4-6. doi: 10.1624/105812404X1707
Lothian JA. Safe, healthy birth: What every pregnant woman needs to know. The Journal of Perinatal Education. 2009; 18(3):48-54. doi: 10.1624/105812409X461225.
Leino-Kilpi H, Välimäki M, Dassen T, Gasull M, Lemonidou C, Scott A, Arndt M. Privacy: A review of the literature. International Journal of Nursing Studies. 2001; 38(6):663-671. https://doi.org/10.1016/S0020-7489(00)00111-5
Hassan SJ, Sundby J, Husseini A, Bjertness E. The paradox of vaginal examination practice during normal childbirth: Palestinian women’s feelings, opinions, knowledge and experiences. Reproductive Health. 2012; 9:16. https://doi.org/10.1186/1742-4755-9-16
Yanikkerem E, Özdemir M, Bingol H, Tatar A, Karadeniz G. Women's attitudes and expectations regarding gynaecological examination. Midwifery. 2009; 25(5):500-508. doi: 10.1016/j.midw.2007.08.006
Blix E. Avoiding disturbance: Midwifery practice in home birth settings in Norway. Midwifery. 2011; 27(5):687-692. https://doi.org/10.1016/j.midw.2009.09.008
Adams ED, Bianchi AL. A practical approach to labor support. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2008; 37(1):106-115. doi: 10.1111/j.1552-6909.2007.00213.x.
Barnett GV. A new way to measure nursing: computer timing of nursing time and support of laboring patients. CIN: Computers, Informatics, Nursing. 2008; 26(4):199-206. doi: 10.1097/01.NCN.0000304805.23499.3f.
Sauls DJ. Dimensions of professional labor support for intrapartum practice. Journal of Nursing Scholarship. 2006; 38(1):36-41. doi: 10.1111/j.1547-5069.2006.00075.x.
Foley BJ, Minick MP, Kee CC. How nurses learn advocacy. Journal of Nursing Scholarship. 2002; 34(2):181-186. doi: 10.1111/j.1547-5069.2002.00181.x.
Singh D, Newburn M. Feathering the nest: what women want from the birth environment. RCM Midwives: The Official Journal of the Royal College of Midwives. 2006; 9(7):266-269.
Janssen PA, Klein MC, Harris SJ, Soolsma J, Seymour LC. Single room maternity care and client satisfaction. Birth. 2000; 27(4):235-43. doi: 10.1046/j.1523-536x.2000.00235.x.
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife‐led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews. 2016; 28:4(4):CD004667. doi: 10.1002/14651858.CD004667.pub5.
Martins ACM, Giugliani ERJ, Nunes LN, Bizon AMBL, de Senna AFK, Paiz JC, de Avilla JC, Giugliani C. Factors associated with a positive childbirth experience in Brazilian women: A cross-sectional study. Women and Birth. 2021; 34(4):e337-e345. doi: 10.1016/j.wombi.2020.06.003.
Olza I, Uvnas-Moberg K, Ekström-Bergström A, Leahy-Warren P, Karlsdottir SI, Nieuwenhuijze M, Villarmea S, Hadjigeorgiou E, Kazmierczak M, Spyridou A, Buckley S. Birth as a neuro-psycho-social event: An integrative model of maternal experiences and their relation to neurohormonal events during childbirth. Plos One. 2020; 28;15(7):e0230992. doi: 10.1371/journal.pone.0230992.
Goldkuhl L, Dellenborg L, Berg M, Wijk H, Nilsson C. The influence and meaning of the birth environment for nulliparous women at a hospital-based labour ward in Sweden: An ethnographic study. Women and Birth. 2022; 35:e337-e347. doi: 10.1016/j.wombi.2021.07.005.
Masoumi SZ, Niazi Z, Bakht R, Roshanaei G. The Effect of Education of Pregnant Women's Bill of Rights to Midwives, on Satisfaction of the Women Referred to Labor Unit of Imam Reza hospital. Avicenna Journal of Nursing and Midwifery Care. 2016; 24:58-67. doi: 10.20286/nmj-24018
Valizadeh F, Ghasemi SF. Human privacy respect from viewpoint of hospitalized patients. European Journal of Translational Myology. 2020; 30:8456. doi: 10.4081/ejtm.2019.8456.
Bingol FB, Bal MD. The risk factors for postpartum posttraumatic stress disorder and depression. Perspectives in Psychiatric Care. 2020; 56.
Witteveen A, Stramrood C, Henrichs J, Flanagan J, Van Pampus M, Olff M. The oxytocinergic system in PTSD following traumatic childbirth: endogenous and exogenous oxytocin in the peripartum period. Archives of Women's Mental Health. 2020; 23(3):317-329. doi: 10.1007/s00737-019-00994-0.
Molgora S, Fenaroli V, Saita E. The association between childbirth experience and mother’s parenting stress: The mediating role of anxiety and depressive symptoms. Women & Health. 2020; 60(3):341-351. doi: 10.1080/03630242.2019.1635563.
Smorti M, Ponti L, Tani F. The effect of maternal depression and anxiety on labour and the well-being of the newborn. Journal of Obstetrics and Gynaecology. 2019; 39(4):492-497. doi: 10.1080/01443615.2018.1536697.
Hussein SAAA, Dahlen HG, Ogunsiji O, Schmied V. Uncovered and disrespected. A qualitative study of Jordanian women’s experience of privacy in birth. Women and Birth. 2020; 33(5):496-504. doi: 10.1016/j.wombi.2019.10.006.
