Disrespect and abuse towards women during childbirth and postpartum depression: findings from Birth in Brazil Study

Leite, Tatiana Henriques; Pereira, Ana Paula Esteves; Leal, María do Carmo; Silva, Antônio Augusto Moura da

doi:10.1016/j.jad.2020.04.052

Cited by 36 publications

(51 citation statements)

References 26 publications

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“…The association between having suffered violence in childbirth and developing PPD was observed in other Brazilian settings [17,21,38]. Research conducted in the southernmost region [17] showed that having suffered verbal violence increases the chance of developing moderate PPD by more than 50% In addition to obstetric violence, the present study identi ed low socioeconomic status and personal history of mental health problems (self-reported by the women) as factors associated with symptoms suggestive of PPD.…”

Section: Discussionsupporting

confidence: 63%

“…It is important to note that the method of measuring obstetric violence adopted for this study differs from other surveys, because there is no standardized way to measure the latent variable, an issue also documented by other authors [21]. Added to this, the use of a lower cut-off point in the EPDS (≥8) for de ning symptoms suggestive of PPD, seeking greater sensitivity, limits the comparison of this study with other surveys.…”

Section: Discussionmentioning

confidence: 95%

“…In the international context, studies show the existence of an association between traumatic experiences in childbirth and higher incidence of post-traumatic stress, anxiety and depression in the early (one week after birth) and late postpartum (04, 06, 12 and 24 weeks postpartum) [19,20]. In this same direction, there are the results of research conducted in Brazil, which demonstrated an association between having suffered disrespect, abuse or violence during childbirth and having PPD [10,21]. When analyzing its subcategories, signi cant association was found between having suffered verbal violence and developing moderate and severe PPD and having suffered physical violence and developing severe PPD.…”

mentioning

confidence: 92%

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Association Between Obstetric Violence and Symptoms Suggestive of Postpartum Depression

Paiz

Castro

Giugliani

et al. 2021

Preprint

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Background: Postpartum depression is a common condition in the pregnancy and postpartum cycle. The development of this condition is multifactorial and can be influenced by previous traumas. This study sought to verify whether there is an association between having been exposed to obstetric violence and presenting symptoms suggestive of postpartum depression.Methods: This is a cross-sectional study, with the inclusion of 287 women without complications in childbirth, randomly selected from two maternity hospitals of Porto Alegre, southern Brazil, in 2016. Four weeks after delivery, the postpartum women answered a face-to-face interview about socioeconomic aspects, obstetric history, health history, and childbirth experience (practices and interventions applied) and completed the Edinburgh Postnatal Depression Scale (EPDS). From the perception of women regarding the practices performed in the context of childbirth care, a composite variable was created, using item response theory, to measure the level of obstetric violence. The items that made up this variable were: absence of a companion during delivery, feeling insecure and not welcome, lack of privacy, lack of skin-to-skin contact after delivery, not having understood the information shared with them, and not having felt comfortable to ask questions and make decisions about their care. To define symptoms suggestive of postpartum depression, reflecting on increased probability of this condition, the EPDS score was set at ≥8. Poisson Regression with robust variance estimation was used for modeling.Results: Women who experienced obstetric violence had a higher prevalence of symptoms suggestive of postpartum depression (PR 1.55 95% CI 1.07-2.25), as well as those with a history of mental health problems (PR 2.41 95% CI 1.15-5.05), while higher socioeconomic status (A and B) had an inverse association (PR 0.38 95% CI 0.19-0.78).Conclusions: Symptoms suggestive of postpartum depression seems to be more prevalent in women who have suffered obstetric violence, of low socioeconomic status, and with a history of mental health problems. Thus, qualifying care for women during pregnancy, childbirth and postpartum and reducing social inequalities are challenges to be faced in order to reduce the occurrence of postpartum depression.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 95%

mentioning

confidence: 92%

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Association Between Obstetric Violence and Symptoms Suggestive of Postpartum Depression

Paiz

Castro

Giugliani

et al. 2021

Preprint

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“…These results have highlighted inequalities in health, since practices that should be implemented during childbirth recorded lower prevalence in these regions [16]. On the other hand, these very same practices were more prevalent in Southeastern Brazil, the most economically developed region in the country [13,16,17].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies about obstetric interventions were carried out in the past decades [13,14,[16][17][18]. However, such interventions were often evaluated in separate [13].…”

Section: Introductionmentioning

confidence: 99%

Coexistence and prevalence of obstetric interventions: an analysis based on the grade of membership

Souza

Silva

Damasceno

et al. 2021

BMC Pregnancy Childbirth

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Background Obstetric interventions performed during delivery do not reflect improvements in obstetric care. Several practices routinely performed during childbirth, without any scientific evidence or basis - such as Kristeller maneuver, routine episiotomy, and movement or feeding restriction - reflect a disrespectful assistance reality that, unfortunately, remains in place in Brazil. The aims of the current study are to assess the coexistence and prevalence of obstetric interventions in maternity hospitals in Belo Horizonte City, based on the Grade of Membership (GoM) method, as well as to investigate sociodemographic and obstetric factors associated with coexistence profiles generated by it. Methods Observational study, based on a cross-sectional design, carried out with data deriving from the study “Nascer em Belo Horizonte: Inquérito sobre o Parto e Nascimento” (Born in Belo Horizonte: Survey on Childbirth and Birth). The herein investigated interventions comprised practices that are clearly useful and should be encouraged; practices that are clearly harmful or ineffective and should be eliminated; and practices that are inappropriately used, in contrast to the ones recommended by the World Health Organization. The analyzed interventions comprised: providing food to parturient women, allowing them to have freedom to move, use of partogram, adopting non-pharmacological methods for pain relief, enema, perineal shaving, lying patients down for delivery, Kristeller maneuver, amniotomy, oxytocin infusion, analgesia and episiotomy. The current study has used GoM to identify the coexistence of the adopted obstetric interventions. Variables such as age, schooling, skin color, primigravida, place-of–delivery financing, number of prenatal consultations, gestational age at delivery, presence of obstetric nurse at delivery time, paid work and presence of companion during delivery were taken into consideration at the time to build patients’ profile. Results Results have highlighted two antagonistic obstetric profiles, namely: profile 1 comprised parturient women who were offered diet, freedom to move, use of partogram, using non-pharmacological methods for pain relief, giving birth in lying position, patients who were not subjected to Kristeller maneuver, episiotomy or amniotomy, women did not receive oxytocin infusion, and analgesia using. Profile 2, in its turn, comprised parturient women who were not offered diet, who were not allowed to have freedom to move, as well as who did not use the partograph or who were subjected to non-pharmacological methods for pain relief. They were subjected to enema, perineal shaving, Kristeller maneuver, amniotomy and oxytocin infusion. In addition, they underwent analgesia and episiotomy. This outcome emphasizes the persistence of an obstetric care model that is not based on scientific evidence. Based on the analysis of factors that influenced the coexistence of obstetric interventions, the presence of obstetric nurses in the healthcare practice has reduced the likelihood of parturient women to belong to profile 2. In addition, childbirth events that took place in public institutions have reduced the likelihood of parturient women to belong to profile 2. Conclusion(s) Based on the analysis of factors that influenced the coexistence of obstetric interventions, financing the hospital for childbirth has increased the likelihood of parturient women to belong to profile 2. However, the likelihood of parturient women to belong to profile 2 has decreased when hospitals had an active obstetric nurse at the delivery room. The current study has contributed to discussions about obstetric interventions, as well as to improve childbirth assistance models. In addition, it has emphasized the need of developing strategies focused on adherence to, and implementation of, assistance models based on scientific evidence.

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The effect of obstetric violence during childbirth on breastfeeding: findings from a perinatal cohort “Birth in Brazil”

Leite

Marques

Mesenburg

et al. 2023

The Lancet Regional Health - Americas

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Disrespect and abuse towards women during childbirth and postpartum depression: findings from Birth in Brazil Study

Cited by 36 publications

References 26 publications

Association Between Obstetric Violence and Symptoms Suggestive of Postpartum Depression

Association Between Obstetric Violence and Symptoms Suggestive of Postpartum Depression

Coexistence and prevalence of obstetric interventions: an analysis based on the grade of membership

The effect of obstetric violence during childbirth on breastfeeding: findings from a perinatal cohort “Birth in Brazil”

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