Obstetric Violence in Their Own Words: How Women in Mexico and South Africa Expect, Experience, and Respond to Violence

Abstract

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.

A qualitative analysis of obstetric violence in rural Madagascar

“…Their research in Kenya and South Africa shows similar structural inequalities which are primarily linked to gender and lead to similar patterns of obstetric violence. According to Smith-Oka et al [ 45 ], local infrastructures, policies and histories allow this violence to continue, especially in countries where violence against women is prevalent and this is unfortunately the case in Madagascar.…”

“…Those who use such services typically have expectations that boil down to what they already know, suggesting that women consider the abuse described above to part of the process of the care pathway. As Smith Oka et al stated “it is important to keep in mind that the women experiencing this violence may not always be the ones at the front lines of activism; despite recognizing that what happened to them was not right, many seem resigned to the idea that things will remain as they currently are" [ 45 p 2716]. They may not always see OV as something that could be regulated, legislated and eradicated [ 45 ].…”

You're joking: Exploring humour and humiliation as forms of shame and obstetric violence within medical encounters

“…Because not all patients have these options, avoiding shame might not be possible and so figuring out ways to cope with it can be part of their experiences as well. 34 The second implication is how to incorporate the concerns of clinicians into these conversations so they do not feel shamed for what they see as appropriate care and protocols. The aim here is not to expose medical humour as problematic-as speech play can serve a key role in medical interactions-but rather to understand how humour within unequal structures can be violent rather than funny.…”

“…They might avoid the hospital or clinic where they have previously been shamed, they might seek out alternative care, or they might refuse care altogether to avoid any potential shameful exposure, even if any of these options could have detrimental effects on their health. Because not all patients have these options, avoiding shame might not be possible and so figuring out ways to cope with it can be part of their experiences as well 34 …”

“Obstetric Violence,” “Mistreatment,” and “Disrespect and Abuse”: Reflections on the Politics of Naming Violations During Facility-Based Childbirth

“…(Kitzinger 1992, 74)Indeed, this naming issue remains a concern today. In their recent ethnographic study on Mexican and South African women's experiences of obstetric violence, Vania Smith-Oka, Sarah Rubin, and Lydia Dixon emphasize that “women knew that something was not right, but there was not always a recourse for them or clear vocabulary to express their concerns” (Smith-Oka, Rubin, and Dixon 2021, 7).…”