Obstetric violence
between women’s perception and childbirth care practices
DOI:
https://doi.org/10.5712/rbmfc19(46)3852Keywords:
Obstetric violence, Comprehensive health care, Parturition.Abstract
Introduction: Childbirth care includes practices that interfere directly in the women’s sense of safeness, well-being and satisfaction. Procedures that are performed without indication or the women’s consent can harm the health of women and their babies and impact their childbirth experience, configuring obstetric violence. Objective: To identify the prevalence of recommended and non-recommended practices in childbirth care, according to the World Health Organization, and the women’s perception of disrespect, mistreatment and abuse. Methods: Cross-sectional study including 287 postpartum women randomly selected in two facilities (private and public) in the city of Porto Alegre in 2016. The participants responded to face-to-face interviews 4 weeks after delivery. A structured questionnaire was used, including variables regarding socioeconomical status, obstetric history, birth experience (care provided and interventions) and the perception of having experienced disrespect, mistreatment, or humiliation by healthcare professionals. Results: Among the interventions, the use of synthetic oxytocin was the most prevalent (56%), followed by amniotomy (48.5%) and episiotomy (37.1%). Uterine fundal pressure maneuver was used in 11.3% of the deliveries; within the private facility, the prevalence was 25.7% compared to 8.2% in the public. Amniotomy was performed in 48.5% of the deliveries; 55.4% in the public facility as opposed to 14.7% in the private. The cesarean section rate in the total sample was 48.1%; however, the rate in the private facility was 82.8%. The proportion of women who felt they were a victim of disrespect, mistreatment or abuse was 12.5%: 14.9% within the public hospital and 7.5% within the private hospital. As for good practices, the incentive to have a companion, the offer of liquids and food, the incentive to move around during labor, the perception of having been welcomed in the maternity ward and skin-to-skin contact were more frequent in the public facility. The feeling of being comfortable asking questions and participating in decisions was more frequent in the private maternity hospital. Conclusions: The application of non-recommended routine practices in childbirth care is frequent in both maternity hospitals. The public maternity hospital showed a higher prevalence of good practices compared to the private one. The prevalence of non-recommended practices is higher than the prevalence of experiencing disrespect, humiliation, or mistreatment during childbirth, as perceived by the postpartum women, suggesting a lack of recognition by women of situations of violence. In this scenario, prenatal care provides a space for exchanging information about good practices and raising awareness about practices considered obstetric violence.
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Copyright (c) 2024 Janini Cristina Paiz, Alice Steglich Souto, Ana Cláudia Magnus Martins, Sarah Maria dos Santos Ahne, Mônica Baréa, Camila Giugliani
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