Childbirth in Chile: Winds of Change

Abstract

They are undoubtedly excellent indicators, but they hide big gaps in access and quality of healthcare between private and public health facilities. Further, there are extremely high routine interventions during childbirth, as indicated by a national cesarean section rate of 50% in 2015 (INDH 2016). In the country, there are no out-of-hospital options for birth that are recognized by the health system and thus covered by health insurance. In 2016, 99.7% of births were attended by health professionals in hospitals (DEIS 2018), where the hegemonic model of practice is the technocratic model of childbirth (Davis-Floyd 2001). A study conducted in nine major regional maternity hospitals, with primiparous and multiparous women who were admitted to the labor ward with 2-3 cm of cervical dilatation and whose physiologic labor was a minimum of 4 h, reported the following interventions: 91% had medically induced/augmented labors, 55% had continuous fetal intrapartum monitoring, 56% had episiotomies, and 80% delivered in the lithotomy position (Binfa et al. 2016). These high rates of interventions are harmful and against national and international guidelines (MINSAL 2008; WHO 2018).

Observations and reports of incidents of how birthing persons are treated during childbirth in two public facilities in Argentina

“…In Latin America and the Caribbean, efforts to ensure respectful maternity care began in the 1970s 5 . Following the issuing of the Ceará Declaration in 2000, birth advocates and public health researchers worked in tandem to support the passage of laws enshrining the rights of childbearing persons 6 . In Argentina, obstetric violence is addressed by the Humanized Birth Law, the Law against Gender Violence, and Safe and Family‐Centered Maternities program, a public policy that stimulates respect for and protection of birthing individuals’ rights 7 .…”

“…5 Following the issuing of the Ceará Declaration in 2000, birth advocates and public health researchers worked in tandem to support the passage of laws enshrining the rights of childbearing persons. 6 In Argentina, obstetric violence is addressed by the Humanized Birth Law, the Law against Gender Violence, and Safe and Family-Centered Maternities program, a public policy that stimulates respect for and protection of birthing individuals' rights. 7 However, despite the aforementioned legislation, there is no systematic registry of obstetric violence/mistreatment, nor are there strong mechanisms in place to help prevent it.…”