Being a midwife in West Africa: Between sensory experiences, moral standards, socio-technical violence and affective constraints

Jaffré, Yannick; Lange, Isabelle

doi:10.1016/j.socscimed.2021.113842

Cited by 10 publications

(4 citation statements)

References 28 publications

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“…All clinical practices not supported by scientific evidence and that which could be carried out in birth rooms are considered by most midwives to be very grave OV, in line with what several authors reported [ 39 , 44 ]. Although Pito Leal et al found that some professionals did not consider some of these practices as OV [ 45 ], there exists findings that are in agreement with other authors [ 18 , 24 , 46 ]. The midwives considered the gravest practice regarding OV to be in the birth room performing a cesarean section or an instrumental birth without clinical justification.…”

Section: Discussionsupporting

confidence: 77%

Obstetric Violence from a Midwife Perspective

Martínez‐Galiano

Rodríguez‐Almagro

Rubio-Álvarez

et al. 2023

IJERPH

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This study examines and determines the prevalence of obstetric violence (OV) as perceived by midwives, as well as their knowledge of it and the professional factors that could be associated with the perception of OV. A cross-sectional study was conducted of 325 midwives in 2021 in Spain. Almost all (92.6%, 301) the midwives knew the term OV, but 74.8% (214) did not believe OV to be the same as malpractice. Moreover, 56.9% (185) stated they had rarely observed OV, and 26.5% (86) regularly observed OV. Most midwives consider physical aggression to be OV, in comparison, not providing information to women was only considered unacceptable treatment. The clinical practice considered the most grave within the context of OV was an instrumental birth or cesarean section without clinical justification. In addition, 97.5% (317) believed that raising awareness on the subject is one of the fundamental points to reducing this problem. Certain factors, such as less work experience, female gender, attendance at home births, and previous training in OV, were associated with an increased perception of situations as OV (p < 0.005). A high percentage of midwives perceived specific clinical practices (e.g., indicate cesarean section without clinical justification or perform the Kristeller maneuver) as OV, and certain characteristics of the professional profile, such as the professional experience or the sex of the midwife, were associated with an increased perception of OV. Most midwives knew the term OV but did not consider that it could pertain to some behaviors included in the international definitions of OV, such as the lack of information provided to a woman or the non-identification of the midwife, among others.

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Section: Discussionsupporting

confidence: 77%

Obstetric Violence from a Midwife Perspective

Martínez‐Galiano

Rodríguez‐Almagro

Rubio-Álvarez

et al. 2023

IJERPH

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“…The topics included mistreatment in maternity settings (n = 58) [ 19 , 21 , 24 , 26 , 30 , 31 , 38 , 39 , 43 , 44 , 46 , 53 , 54 , 59 , 60 , 63 , 75 , 85 , 88 , 90 , 97 – 102 , 120 , 122 – 124 , 140 , 148 , 150 , 151 , 154 – 157 , 159 – 161 , 167 , 169 , 171 – 173 , 215 , 218 , 219 , 220 , 222 , 224 – 226 , 229 , 230 , 235 , 236 ]; physical restraint in mental health settings (n = 30) [ 23 , 32 , 40 , 41 , 48 – 51 , ...…”

Section: Resultsmentioning

confidence: 99%

Theories for interventions to reduce physical and verbal abuse: A mixed methods review of the health and social care literature to inform future maternity care

Downe

Nowland

Clegg

et al. 2023

PLOS Glob Public Health

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Despite global attention, physical and verbal abuse remains prevalent in maternity and newborn healthcare. We aimed to establish theoretical principles for interventions to reduce such abuse. We undertook a mixed methods systematic review of health and social care literature (MEDLINE, SocINDEX, Global Index Medicus, CINAHL, Cochrane Library, Sept 29th 2020 and March 22nd 2022: no date or language restrictions). Papers that included theory were analysed narratively. Those with suitable outcome measures were meta-analysed. We used convergence results synthesis to integrate findings. In September 2020, 193 papers were retained (17,628 hits). 154 provided theoretical explanations; 38 were controlled studies. The update generated 39 studies (2695 hits), plus five from reference lists (12 controlled studies). A wide range of explicit and implicit theories were proposed. Eleven non-maternity controlled studies could be meta-analysed, but only for physical restraint, showing little intervention effect. Most interventions were multi-component. Synthesis suggests that a combination of systems level and behavioural change models might be effective. The maternity intervention studies could all be mapped to this approach. Two particular adverse contexts emerged; social normalisation of violence across the socio-ecological system, especially for ‘othered’ groups; and the belief that mistreatment is necessary to minimise clinical harm. The ethos and therefore the expression of mistreatment at each level of the system is moderated by the individuals who enact the system, through what they feel they can control, what is socially normal, and what benefits them in that context. Interventions to reduce verbal and physical abuse in maternity care should be locally tailored, and informed by theories encompassing all socio-ecological levels, and the psychological and emotional responses of individuals working within them. Attention should be paid to social normalisation of violence against ‘othered’ groups, and to the belief that intrapartum maternal mistreatment can optimise safe outcomes.

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“…Previous studies have described how non-medical factors shape many of the practices surrounding childbirth in Sub-Saharan Africa, from both a patient and a health provider perspective. 18–21 Alternative childbirth and labour practices to the biomedical protocol have also been identified all around the world. 22 , 23 In Benin, we identified practices such as prayer, scarifications, divination and herbal medicines to tackle the social, spiritual and biological forces at play in “the battle” of childbirth.…”

Section: Discussionmentioning

confidence: 99%

“To give life is a journey through the unknown”: an ethnographic account of childbirth experiences and practices in Southern Benin

Vigan,

Dossou,

Boyi

et al. 2023

Sexual and Reproductive Health Matters

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In Benin maternal mortality remains high at 397 deaths per 100,000 live births, despite 80% of births being attended by skilled birth attendants in health facilities. To identify childbirth practices that potentially contribute to this trend, an ethnographic study was conducted on the use of biomedical and alternative health services along the continuum of maternal care in Allada, Benin. Data collection techniques included in-depth interviews ( N = 83), informal interviews ( N = 86), observations ( N = 32) and group discussions ( N = 3). Informants included biomedical, spiritual and alternative care providers and community members with a variety of socioeconomic and religious profiles. In Southern Benin alternative and spiritual care, inspired by the Vodoun, Christian or Muslim religions, is commonly used in addition to biomedical care. As childbirth is perceived as a “risky journey to the unknown”, these care modalities aim to protect the mother and child from malevolent spirits, facilitate the birth and limit postpartum complications using herbal decoctions and spiritual rites and rituals. These practices are based on mystical interpretations of childbirth that result in the need for additional care during facility-based childbirth. Because such complementary care is not foreseen in health facilities, facility-based childbirth is initiated only at an advanced stage of labour or at the onset of a perceived immediate life-threatening complication for the mother or baby. Programmes and policies to reduce maternal mortality in Benin must seek synergies with alternative providers and practices and consider the complementary and integrated use of alternative and spiritual care practices that are not harmful.

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Being a midwife in West Africa: Between sensory experiences, moral standards, socio-technical violence and affective constraints

Cited by 10 publications

References 28 publications

Obstetric Violence from a Midwife Perspective

Obstetric Violence from a Midwife Perspective

Theories for interventions to reduce physical and verbal abuse: A mixed methods review of the health and social care literature to inform future maternity care

“To give life is a journey through the unknown”: an ethnographic account of childbirth experiences and practices in Southern Benin

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