Disrespect and Abuse in Obstetric Care in Mexico: An Observational Study of Deliveries in Four Hospitals

Monge, Alexander Brenes; Elorriaga, María Fernández; Verástegui, Ofelia Poblano; Valdez‐Santiago, Rosario; Nolasco, Manuel A Martínez; Álvarez, Irais Yáñez; Saturno-Hernández, Pedro Jesús

doi:10.1007/s10995-020-03052-9

Cited by 7 publications

(7 citation statements)

References 22 publications

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“…The results of this study was higher than those of studies conducted in Mexico (18.8%) ( 69 ), Brazil (18.3%) ( 70 ) and India (28%) ( 71 ) in comparison. Socioeconomic differences, variations in healthcare providers’ knowledge, attitudes, and skills, variations in healthcare facilities and systems, variations in study time and sampling methods, and differences in how disrespect and abuse of women during childbirth are defined at various healthcare facilities could all be contributing factors.…”

Section: Discussioncontrasting

confidence: 86%

Disrespect and abuse of women during childbirth at health facilities in Eastern Africa: systematic review and meta-analysis

2023

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BackgroundDisrespectful and abusive maternity care is a sign of poor treatment that influences women’s choice to deliver their babies in institutions. Such malpractices continue to go unreported and are rarely exposed in developing countries, despite their serious burden. Therefore, this meta-analysis study aimed to estimate disrespect and abuse of women during childbirth in East Africa.MethodsPubMed, Google Scholar, Scopus, and Science Direct databases were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg’s rank test, and Egger’s regression test. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by study region, sample size, and publication. The pooled odds ratio for associated factors was also computed.ResultsOut of 654 articles assessed, 18 met the criteria and were included in this study. There were a total of 12,434 study participants. The pooled prevalence of disrespect and abuse of women during childbirth in East Africa was 46.85% (95% CI: 45.26.72–66.98), I2 = 81.9%. It was lower in studies with sample size greater than 5000 (33%). The disrespect and abuse rates between community-based studies (44.96%) and institutional-based studies (47.35%) did not differ significantly, though. Instrumental delivery (AOR = 2.70; 95%CI: 1.79–4.08), presence of complications (AOR = 6.41; 95% CI: 1.36–30.14), receiving care at government hospitals (AOR = 3.66; 95% CI: 1.09–12.23), and poor wealth index (AOR = 2.16; 95% CI: 1.26–3.70) were associated factors.ConclusionIn East Africa, disrespect and abuse of women during childbirth was high. Instrumental delivery, presence of complications during childbirth, receiving care at government hospitals and poor wealth index were predictors of maternal disrespect and abuse. Safe delivery practice should be promoted. Training in compassionate and respectful maternity care, particularly in public hospitals, has also been recommended.

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Section: Discussioncontrasting

confidence: 86%

Disrespect and abuse of women during childbirth at health facilities in Eastern Africa: systematic review and meta-analysis

2023

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“…With rates between 18 and 33% [ 18 , 19 ], existing literature has shown a high prevalence of abuse and disrespect during childbirth delivery in Mexico; however, most of the literature has been qualitative or limited to a city or state [ 18 – 21 ]. Given the high rates of unnecessary C-sections in Mexico, identifying the occurrence and risk factors of non-consented C-sections on a larger scale could improve our understanding of the extent of the problem and how to address it.…”

Section: Introductionmentioning

confidence: 99%

Association between location of prenatal care services and non-consented cesarean sections in Mexico: A secondary analysis of the National Survey on the Dynamics of Household Relationships 2016

Marian,

Pérez

2024

PLoS ONE

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Background Mexico has one of the world’s highest rates of cesarean section (C-section). Little is known about Mexico’s frequency of and risk factors for non-consented C-sections, a form of obstetric violence. We examined the prevalence of sociodemographic and obstetric-specific characteristics of Mexican women who delivered via C-section, as well as the association between the location of prenatal care services and experiencing a non-consented C-section. Methods We conducted a secondary analysis of data collected from Mexico’s 2016 National Survey on the Dynamics of Household Relationships (ENDIREH 2016) of women who reported a C-section during their latest delivery. Adjusted logistic regressions were calculated to explore the associations between the location of prenatal care services and experiencing a non-consented cesarean delivery, stratifying by Indigenous belonging. Results The sample size for this analysis was 10,256 ENDIREH respondents, with 9.1% not consenting to a C-section. ENDIREH respondents between the ages of 26 and 35 years old, living in urban settings, living in Central or Southern Mexico, and married or living with a partner experienced a higher prevalence of non-consented C-sections. For both women who identified as Indigenous and those who did not, the odds of experiencing a non-consented C-section were higher when receiving prenatal services in private settings. Receiving more than one type of prenatal service was also associated with increased odds of non-consented C-sections, while ENDIREH 2016 respondents who did not identify as Indigenous and received prenatal care at the State Institute for Social Security and Services for State Workers facility had lower odds of experiencing a non-consented C-section. Conclusions This analysis indicates that receiving prenatal care at a private facility or a combination of public and private services increases the risk of experiencing a non-consented C-section in Mexico. Additional research is required to further understand the factors associated with non-consented C-sections in Mexico.

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“…Notably, obstetric violence is a prevalent phenomenon in Latin America [ 13 , 19 ], with an estimated 43% of women having experienced abuse and mistreatment during childbirth [ 19 ], and documented presence of non-consented care in several countries of this region [ 10 ]. Specifically, in Mexico, the prevalence of obstetric violence in the past fifteen years ranges from 6 to 33%, based on previous studies conducted at the city level in two cities in Central Mexico [ 20 ]. The denial of care to Indigenous women and unnecessary C-sections in this country are forms of obstetric violence particularly identified in the literature [ 11 , 21 – 23 ].…”

Section: Introductionmentioning

confidence: 99%

“…The denial of care to Indigenous women and unnecessary C-sections in this country are forms of obstetric violence particularly identified in the literature [ 11 , 21 – 23 ]. Specific to non-consented care, a mixed-methods study completed in four hospitals across the Mexican states of Puebla and Chiapas found that more than 50% of women experienced non-consented care, as they did not receive adequate information for three invasive procedures (genital cleansing, genital shaving, and enema administration) and did not provide consent for them [ 20 ]. Episiotomies, manual uterine cavity revisions, and vaginal examinations are other procedures that have been found to be practiced in Mexico without the consent of female patients during childbirth [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of different variations of non-consented care during the childbirth process in Mexico by geographical regions: comparing ENDIREH survey data from 2016 to 2021

Marian,

Barker,

Reed

et al. 2024

BMC Pregnancy Childbirth

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Introduction Non-consented care, a form of obstetric violence involving the lack of informed consent for procedures, is a common but little-understood phenomenon in the global public health arena. The aim of this secondary analysis was to measure the prevalence and assess change over time of non-consented care during childbirth in Mexico in 2016 and 2021, as well as to examine the association of sociodemographic, pregnancy-, and childbirth-factors with this type of violence. Methods We measured the prevalence of non-consented care and three of its variations, forced sterilization or contraception, forced cesarean section, and forced consent on paperwork, during childbirth in Mexico for 2016 (N = 24,036) and 2021 (N = 19,322) using data from Mexico’s cross-sectional National Survey on the Dynamics of Household Relationships (ENDIREH). Weighted data were stratified by geographical regions. We performed adjusted logistic regression analyses to explore associations. Results The national prevalence of non-consented care and one of its variations, pressure to get a contraceptive method, increased from 2016 to 2021. A decrease in the prevalence was observed for forced contraception or sterilization without knowledge, forcing women to sign paperwork, and non-consented cesarean sections nationally and in most regions. Women between the ages of 26 and 35 years, married, cohabiting with partner, living in urban settings, who do not identify as Indigenous, and who received prenatal services or gave birth at the Mexican Institute of Social Security (IMSS) facilities experienced a higher prevalence of non-consented care. Being 26 years of age and older, living in a rural setting, experiencing stillbirths in the last five years, having a vaginal delivery, receiving prenatal services at IMSS, or delivering at a private facility were significantly associated with higher odds of reporting non-consented care. Conclusion While a decrease in most of the variations of non-consented care was found, the overall prevalence of non-consented care and, in one of its variations, pressure to get contraceptives, increased at a national and regional level. Our findings suggest the need to enforce current laws and strengthen health systems, paying special attention to the geographical regions and populations that have experienced higher reported cases of this structural problem.

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Disrespect and Abuse in Obstetric Care in Mexico: An Observational Study of Deliveries in Four Hospitals

Cited by 7 publications

References 22 publications

Disrespect and abuse of women during childbirth at health facilities in Eastern Africa: systematic review and meta-analysis

Disrespect and abuse of women during childbirth at health facilities in Eastern Africa: systematic review and meta-analysis

Association between location of prenatal care services and non-consented cesarean sections in Mexico: A secondary analysis of the National Survey on the Dynamics of Household Relationships 2016

Prevalence of different variations of non-consented care during the childbirth process in Mexico by geographical regions: comparing ENDIREH survey data from 2016 to 2021

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