Obstetric Violence in Spain (Part III): Healthcare Professionals, Times, and Areas

Abstract

Background: Obstetric violence is a worldwide public health problem, which seems greater in Spain. As no studies were found that identify the most representative healthcare professionals, times, and areas involved in obstetric violence, the objective of this work was to study at what time of maternity, with which professionals, and in what areas women identified obstetric violence. Methods: This descriptive, retrospective, and cross-sectional study was performed from January 2018 to June 2019. The main variables were the area (hospital, primary care, both), the time (pregnancy, birth, puerperium), and the professionals attending to women. Results: Our sample comprised 17,541 participants. The area identified with the most obstetric violence for the different studied variables was hospitals. Women identified more obstetric violence at time of birth. Findings such as lack of information and informed consent (74.2%), and criticism of infantile behavior and treatment (87.6%), stood out. The main identified healthcare professionals were midwives and gynecologists, and “other” professionals repeatedly appeared. Conclusions: Having identified the professionals, times, and areas of most obstetric violence in Spain, it seems necessary to reflect on not only the Spanish National Health System’s structure and management but also on healthcare professionals’ training.

Obstetric violence and associated factors among women during facility based childbirth at Gedeo Zone, South Ethiopia

“…According to a study conducted in Spain, the magnitude of the problem was alarming, with nearly half of women responding negatively if they had received unnecessary and/or painful procedures while giving birth [11], and hospitals being identified as the area with the most obstetric violence for the various studied variables. Findings such as lack of information and informed consent (74.2%) and criticism of infantile behavior and treatment (87.6%) indicate that women experienced more obstetric violence during childbirth [17].…”

Obstetric Violence as an Infringement on Basic Bioethical Principles. Reflections Inspired by Focus Groups with Midwives

“…Beyond the concept of obstetric violence, what matters is that, according to midwives, during childbirth women experience “aggression”, “harm”, or “mistreatment” that can be physical, verbal, emotional, psychological, or moral [ 24 ]: “Aggressions that women suffer within the healthcare environment, and by aggression I mean verbal, physical, and emotional.” (Sara, group A)…”

“…In the context of childbirth, this has also been defined as a “respectful maternity care” [ 27 ], which is often harmed as childbirth is seen as a medical procedure and not as a natural process. Consequently, women are not treated as persons, but as objects, so they experience a dehumanized care that affects their dignity and depersonalizes them [ 24 ]. According to midwives, this dehumanized care entails abuse, disrespect, humiliation, tactless attitudes, a lack of education, a lack of intimacy (i.e., leaving doors open in labor rooms), infantilization, and even therapeutic persistence: “It suggests to me an abuse to integrity…” (Carol, group B) “Acts of humiliation, lack of respect…” (Cameron, group C) “Sometimes the words we use like ‘mummy’ and ‘daddy’, these kinds of things that are used that are totally inappropriate and that infantilize the woman and make no sense.” (Amy, group B) “I associate it with therapeutic cruelty.” (Hugh, group C) “As for that WHO says, which defines it as a lack of respect and considers it as a public health issue, I totally agree.” (Sara, group A)…”

Violência Obstétrica Na Paraíba (Brasil): Relatos E Experiências De Mães

“…Segundo as parteiras, a VO viola os princípios básicos da bioética, tanto os americanos (não maleficência, beneficência, autonomia e justiça) e os europeus (vulnerabilidade, integridade e dignidade), que não devem ser vistos separadamente, mas intrinsecamente interligados (MARTÍN-BADIA; OBREGÓN-GUTIÉRREZ; GOBERNA-TRICAS, 2021 MENA-TUDELA et al, 2021).…”

“…As mulheres não são vistas como seres biopsicossociais, por isso sua dignidade é frequentemente danificada e, em última análise, o seu bem-estar é diminuído (violação da integridade, princípios de dignidade e beneficência). Elas não estão plenamente conscientes de seus direitos e sua capacidade de decisão não é promovida (violação do princípio da autonomia) (MARTÍN-BADIA; OBREGÓN-GUTIÉRREZ; GOBERNA-TRICAS, 2021 MENA-TUDELA et al, 2021).…”