Breaking the silence about obstetric violence: Body mapping women’s narratives of respect, disrespect and abuse during childbirth in Bihar, India

Abstract

Background Evidence on obstetric violence is reported globally. In India, research shows that almost every woman goes through some level of disrespect and abuse during childbirth, more so in states such as Bihar where over 70% of women give birth in hospitals. Objective 1) To understand how women experience and attach meaning to respect, disrespect and abuse during childbirth; and 2) document women’s expectations of respectful care. Methods ‘Body mapping’, an arts-based participatory method, was applied. The analysis is based on in-depth interviews with eight women who participated in the body mapping exercise at their homes in urban slums and rural villages. Analysis was guided by feminist relational discourse analysis. Findings Women reported their experiences of birthing at home, public facilities, and private hospitals in simple terms of what they felt ‘good’ and ‘bad’. Good experiences included being spoken to nicely, respecting privacy, companion of choice, a bed to rest, timely care, lesser interventions, obtaining consent for vaginal examination and cesarean section, and better communication. Bad experiences included unconsented interventions including multiple vaginal examinations by different care providers, unanesthetized episiotomy, repairs and uterine exploration, verbal, physical, sexual abuse, extortion, detention and lack of privacy. Discussion The body maps capturing birth experiences, created through a participatory method, accurately portray women’s respectful and disrespectful births and are useful to understand women’s experience of a sensitive issue in a patriarchal culture. An in-depth understanding of women’s choices, experiences and expectations can inform changes practices in and policies and help to develop a culture of sharing birth experiences.

Obstetric violence and disability overlaps: obstetric violence during child birth among womens with disabilities: a qualitative study

“…This explanation parallels other literature in the area ([ 19 , 29 , 30 ] . The same experience was also there in India where the sister (nurse) gave a laboring woman two tight slaps across her face [ 31 ] .…”

“…Nigerian study also explained that women suffered of being insult by obstetric care providers [ 7 , 29 , 30 ]. The study in India also showed the birth experience of women as the nurses committed verbal abuse by shouting at the laboring women [ 31 ].…”

Evaluation of community-based participatory governance interventions to improve access to health-related public entitlements in India

“…Several studies show that the persons who are disadvantaged by location, race, class, gender and other power differentials are denied voices, they are ill-treated by the system (Goetz and Jenkins, 2002; Mukhopadhyay and Meer, 2004). For example, rude behavior of health staff toward women availing reproductive health services was reported in many Indian states (Murthy, 1999; Mayra et al. , 2022; Sudhinaraset et al.…”

“…Several studies show that the persons who are disadvantaged by location, race, class, gender and other power differentials are denied voices, they are ill-treated by the system (Goetz and Jenkins, 2002;Mukhopadhyay and Meer, 2004). For example, rude behavior of health staff toward women availing reproductive health services was reported in many Indian states (Murthy, 1999;Mayra et al, 2022;Sudhinaraset et al, 2016) and abuse of nurses was reported by the women availing obstetric services in several African countries (Jewkes et al, 1998;Shimoda et al, 2020;Oluoch-Aridi et al, 2018;Mapumulo et al, 2021). The lack of accurate information, which is fundamental for the utilization of health services, is an important challenge leading to poor access as seen in past research (Jacobs et al, 2012;Thakur, 2016;Kusuma et al, 2018).…”

Birth Mapping: A Visual Arts-Based Participatory Research Method Embedded in Feminist Epistemology

“…Research with women about their sensitive embodied experiences poses significant challenges when discussing their lived experiences of healthcare. In some country’s contexts and cultures, such as India, it is uncomfortable and/or taboo for women to discuss reproductive and sexual health and needs, contributing to the embarrassment stemming from a strong culture of silence and shame around it (Bhatt, 2018; Mayra et al, 2022; Pande et al, 2016; Paul et al, 2017; Santhya et al, 2010; Yari et al, 2015). These challenges are compounded by the gender and power differentials between them and people around them, in the home and obstetric environment (Sprague, 2016).…”