Components of obstetric violence in health facilities in Quito, Ecuador: A descriptive study on information, accompaniment, and position during childbirth

Abstract

Objective: To describe three factors of obstetric violence in health centers that attend births in Quito, Ecuador: information; accompaniment; and free position. Method:A cross-sectional descriptive study of 388 women was conducted, focusing on the analysis of three factors of obstetric violence. This study forms part of a larger study that explores the experiences of women in childbirth in Quito between July 1, 2016 and July 1, 2017.Results: Of all procedures, the performance of episiotomies and the application of fundal pressure during the second stage of labor (Kristeller) stand out, as more than 35% of the women were not informed about them. In total, 121 (46.9%) women who gave birth vaginally were not given the opportunity to be accompanied by someone of their choice, neither in labor nor during delivery. While in the cases of cesarean deliveries, this increased to 116 (92.1%) women. A total of 119 (37.2%) women did not have the opportunity to choose their birthing position (or they did not know they could choose).During delivery, 138 (53.5%) women indicated the same. Conclusion:Obstetric violence is seen in all three components: information; accompaniment; and free position. K E Y W O R D S

Potential of Standard Perinatal Data for Measuring Violation of Birth Integrity

“…Studies on vBI have found that it is a frequently used procedure although there is no evidence of its benefit. Instead, it carries high vBI potential and the WHO recommendations strongly discourage it due to its potential for harm ( 11 , 37 – 39 ).…”

Reliability and Dimensionality of EPREVO (“Experiencias de Parto Relacionadas a Violencia Obstétrica”): Development of a New Instrument, Ecuador

“… 8 , 9 The high number of obstetric violence in the country constitutes a serious public health subject that implies individual consequences in the short and long term, these are not only physical but also psychological and social. 8 , 10…”

“…7 In Ecuador, there are demonstrations of obstetric violence in public and private health units, including indiscriminate vaginal touching, caesarean sections without medical reason, routine episiotomies, separation of the newborn from his mother, not offering help to start maternal breastfeeding, among others. 8,9 The high number of obstetric violence in the country constitutes a serious public health subject that implies individual consequences in the short and long term, these are not only physical but also psychological and social. 8,10 In an investigation in Quito 9 where it was reported that 120 women who gave birth for the first time, 62 (51.7%) had an episiotomy.…”

“…8,9 The high number of obstetric violence in the country constitutes a serious public health subject that implies individual consequences in the short and long term, these are not only physical but also psychological and social. 8,10 In an investigation in Quito 9 where it was reported that 120 women who gave birth for the first time, 62 (51.7%) had an episiotomy. In the second stage of labor, the Kristeller maneuver was performed in 49 (19.4%) of 252 women.…”

Design and Validation of the PercOV-S Questionnaire for Measuring Perceived Obstetric Violence in Nursing, Midwifery and Medical Students

“…Studies identify that approximately 30% of childbirth experiences can be considered traumatic and/or as having OV components [5,6]. Moreover, OV can be found around the world in all continents: America [7][8][9], Africa [10][11][12], Asia [13], Europe [6,14,15] and Australia [16,17]. These negative experiences and the presence or practice of OV have consequences for the woman and her newborn, for society and for the health professionals who observe or practice it.…”