To design and validate a tool to assess a woman's perception of whether she has experienced a situation of abuse or disrespect during childbirth attendance: “Childbirth Abuse and Respect ...Evaluation-Maternal Questionnaire” (CARE-MQ).
Multidisciplinary panel of experts (gynecologists, midwives, mothers) participated in creating CARE-MQ. A cross-sectional study was carried out on 901 Spanish women who had given birth between 1 and 3 months before to determine psychometric characteristics. Finally, an exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and a convergent validity study were carried out with the Quality Questionnaire from the Patient's Perspective-Intrapartum (QPP-I), and a reliability study using internal consistency (Cronbach's α) and coefficient of intraclass correlation (CCI).
The KMO test gave a value of 0.935, and Bartlett's sphericity test was <0.001. The EFA identified four components (“Emotional Abuse”, “Inadequate Professionalism”, “Physical Abuse” y “Lost contact”) that explained 55.16 % of variance. In the CFA, a good fit was observed for most of the evaluated indicators. CARE-MQ correlated negatively with QPP-I (Spearman's rho = −0.641, 95 % CI: −0.679, −0.600; p < 0.001) and was statistically associated with variables related to childbirth experience (p < 0.005) such as the use of a birth plan, use of regional analgesia, type of birth, episiotomy, presence of severe tears, skin-to-skin contact, length of hospital stay and postpartum surgical intervention. Cronbach's α value was 0.903. The ICC of absolute agreement after administering the questionnaire one week after was 0.927 (95 % CI: 0.85–0.97).
CARE-MQ is a valid and reliable instrument to evaluate the perception of a woman regarding the situation of abuse and/or disrespect that she may have experienced during birth in a population of Spanish postpartum women.
Introduction of the dossier: Critical social approaches to obstetric violence. A Latin American category for a global problem
Introdução do dossiê: Abordagens sociais críticas à violência ...obstétrica. Uma categoria latino-americana para um problema global
Presentación de dossier: Enfoques sociales críticos de la violencia obstétrica. Una categoría latinoamericana para un problema global
Towards the language analysis performed on two recommendations issued by the local human rights commission located in San Luis Potosí, México, this paper pretends to uncover the institutional ...dimension of obstetric violence which acts on a local level of health authorities. The analysis stands by a concept of obstetric violence as a systematic violences accumulation committed on the women’s bodies produced by an (undiminished) hospital-structural failure; but also, a poor performs on the medical state public services affected by the communitarian and political life of those women. This analysis also involves the human rights dimension of women on this form of violence, which stands on the before said, local level of healthcare public system. The research was structured with a qualitative approach through the selection of secondary information sources towards two recommendations issued by the human rights’ local authority. The information sources were purely based on the content of the violations present on each document, taking on consideration the human right gross violations and the quality of the recommendations.
Giving Birth in Silence Chang, Fu-Yu; Aguirre, Jacinta
Medicine Anthropology Theory,
09/2023, Letnik:
10, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Jacinta, deaf from birth, chose to give birth to her own baby at home without her hearing aids. Fu-Yu assisted and took photos of the process. This is a Photo Essay about alternative possibilities to ...biomedical childbirth. We share our experience through this medium, as the ‘visual’ was our shared sensory perception at the time. Besides acknowledging the intersubjectivities that surfaced, we see the importance of recognising that ‘images are representations of the world filtered by the positionalities of the makers themselves, influenced by unique experiences that brought them to that point in time … Images become an extension of a way of thinking, visually connecting maker with participant along lines of thought’ (Cartwright and Crowder 2017, 515). Although Fu-Yu is the one operating the camera, Jacinta, her partner, her mother, her cat and her home ‘make the image’. Whilst Jacinta was in labour, Fu-Yu was assisting Carmen Susana (the midwife) and recording the event at the same time with a camera hanging around her neck. We want to offer the audience this shared ‘visual’ experience as an invitation to think and ‘visualise’ care and childbirth from a disability-studies perspective.
Engaging in dialogue with critical mothers, midwives, midwives in training, and doulas in the Netherlands, this study furthers the theoretical understanding of both obstetric violence and the ...activist resistance against it. Obstetric violence is understood as part of a process of relational separation, leaving the pregnant person isolated. The activist resistance against it is consequently theorized as the abolitionist building of an alternative "otherworld" of radical relational care. The themes established are: (1) "institutionalized separation" with the subtheme's "expropriation," "carcerality," and "obstetric violence;" and (2) "undercommoning childbirth" with subthemes "fugitive planning," "anarchic relationality," and "obstetric abolition."
Who is afraid of obstetric violence? Katz, Leila; Amorim, Melania Maria; Giordano, Juliana Camargo ...
Revista Brasileira de Saúde Materno Infantil,
06/2020, Letnik:
20, Številka:
2
Journal Article
Odprti dostop
Abstract Despite being a relatively new term, obstetric violence is an old problem. In 2014, the World Health Organization declared: “Many women experience disrespectful and abusive treatment during ...childbirth in facilities worldwide. Such treatment not only violates the rights of women to respectful care, but can also threaten their rights to life, health, bodily integrity, and freedom from discrimination”. This problem, named as “abuse”, “disrespect” and/or “mistreatment” during childbirth, has been addressed in several studies. However, there has been no consensus on how to properly name this problem, although its typology has been well described. Considering the magnitude of this problem, it is essential to give the correct terminology to this important health and human rights issue. Naming it as obstetric violence and understanding it as gender-based violence will ensure appropriate interventions to avert this violation of women's rights.
Resumo Apesar de ser um termo relativamente novo, a violência obstétrica é um problema antigo. Em 2014, a Organização Mundial da Saúde declarou: “Muitas mulheres sofrem tratamento desrespeitoso e abusivo durante o parto em instalações de saúde em todo o mundo. Esse tratamento não só viola os direitos das mulheres a cuidados respeitosos, mas também pode ameaçar seus direitos à vida, saúde, integridade corporal e liberdade de discriminação”. Esse problema, denominado “abuso”, “desrespeito” e /ou “maus-tratos” durante o parto, foi abordado em vários estudos. No entanto, não houve consenso sobre como nomear adequadamente esse problema, embora sua tipologia tenha sido bem descrita. Considerando a magnitude desse problema, é essencial dar a terminologia correta para essa importante questão de saúde e direitos humanos. Nomear como violência obstétrica e entendê-la como violência baseada em gênero garantirá intervenções apropriadas para evitar essa violação dos direitos das mulheres.
The topic of obstetric and gynecological aggression is a widespread topics, but at the same taboo. The reason is the stigma and fear of women who have been subjected to medical violence. This is ...something that is not spoken out loud, is not put on public display, because behind it lies pain and shame. Therefore, they do not attach any importance to the topic of obstetric violence. According to modern data, every third woman in the world suffers from the inhumane actions of obstetricians. And these actions lead to irreparable consequences in the life of every woman. The purpose of the study is to assess the impact of obstetric violence on the quality of a woman's life.
Background. To identify the main ways of overcoming this problem. It was established that the negative experience of visiting a gynecologist associated with feeling of pain causes a feeling of fear before the next examination, this reduces visits to preventive examinations, which can lead to the detection of diseases at later stages of its development and complicate the treatment. The negative experience of visiting a gynecologist associated with the feeling of pain worsens the quality of life of a woman according to the indicators of the “Mental health” component. Establishing the presence of factors of obstetric and gynecological violence requires psychological assistance to patients and the development of ethical approaches to the provision of medical care by doctors and medical personnel and the improvement of pain relief methods
Objective This study determined the prevalence of obstetric violence experienced by women during childbirth and related factors in Türkiye.
Design Cross-sectional study
Setting This study was ...conducted in the mother-child health and gynecology outpatient clinics of the training and research hospital in Türkiye.
Participants The study was completed with 513 women who gave birth in the last two years between January and May 2022.
Methods Data were collected using a questionnaire prepared by the researchers. Bivariate and multivariate logistic regression analyzed the relationship between obstetric violence and socio-demographic and obstetric characteristics.
Findings Obstetric violence was reported by 76.4% of the women: 44.4% physical abuse, 44.4% abandonment of care, 26.5% non-consented care, 25.1% non-dignified care, 3.3% non-confidential care, and 0.4% discrimination. Low income (OR=1.98), physician-attended birth (OR=2.91), vaginal birth (OR=6.04), and newborn admission to the neonatal care unit (OR=2.99) were associated with higher reporting of obstetric violence. Primiparous women (OR=0.51), whose pain was controlled by non-pharmacological methods (OR=0.34) and who received companion support (OR=0.24) were less likely to report experiencing obstetric violence (p < 0.05).
Key conclusions Approximately three out of four Turkish women report that they have been exposed to obstetric violence during childbirth. In Türkiye, vaginal birth is the type of childbirth with the highest rate of obstetric violence reporting. Women who are low-income and multiparous, who are deprived of midwife, companion, and pain control support during childbirth, are more likely to experience obstetric violence.
Implications for practice Supporting low-income women, protecting women from traumatic acts and unnecessary interventions in a vaginal birth, increasing births under the attendance of midwives, and providing pain control with non-pharmacological methods, and companion support during labor may be protective factors against obstetric violence.
This article, based on ethnographic research in Mexico and South Africa, presents two central arguments about obstetric violence: (a) structural inequalities across diverse global sites are primarily ...linked to gender and lead to similar patterns of obstetric violence, and (b) ethnography is a powerful method to give voice to women's stories. Connecting these two arguments is a temporal model to understand how women across the world come to expect, experience, and respond to obstetric violence—that is, before, during, and after the encounter. This temporal approach is a core feature of ethnography, which requires long-term immersion and attention to context.
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