Obstetric Violence from a Midwife Perspective

Abstract

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.

The Childbirth Experiences of Pregnant Women Living with HIV Virus: Scoping Review

“…It is a challenge for PWLWHIV and healthcare professionals to equally prioritise the prevention of vertical transmission of HIV and the humanisation of childbirth. The second major challenge is to reduce the negative childbirth experience, which has been increasing among pregnant women in general [ 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ].…”

Cultural Adaptation, Validation and Evaluation of the Psychometric Properties of an Obstetric Violence Scale in the Spanish Context

“…In this regard, it is important to point out that informed consent (regulated in Spain by Law 41/2002 14 November 2002 on patients’ autonomy and rights and duties regarding information and clinical documentation [ 64 ]) must be requested from all patients before any intervention and not doing so entails OV [ 4 , 6 , 8 , 9 ].…”

“…OV also includes any practice or attitude affecting a woman’s psychological wellbeing, e.g., treating her as a child, adopting paternalistic or authoritarian attitudes, behaving in a derogatory way, humiliating or insulting her, etc. [ 1 , 3 , 6 , 7 , 9 ].…”

“…Analysis of the differences in OV prevalence must take into account the complexity of the construct [ 2 , 4 , 31 ] which, as mentioned, includes several attitudes and practices deeply influenced by social or cultural aspects as well as by medical factors [ 6 , 7 ]. Certain practices considered as OV may be not perceived as such by women or health professionals in certain contexts, which consequently influences the reported rates [ 2 , 6 , 9 , 32 ].…”

Aproximaciones para comprender y prevenir la violencia obstétrica

“…Tomando como punto de partida el análisis de las relaciones de poder y quién lo ejerce, algunos proponen distinguir entre definiciones objetivas (aquellas que no parten de la experiencia personal para definir un fenómeno social) y las definiciones subjetivas, que incluyen aquellas que parten desde la experiencia de las mujeres y la sociedad civil (39)(40)(41), así como las del personal de salud (42). Las definiciones objetivas, entendidas como las técnicas y prácticas biomédicas, basadas en evidencia científica, adquiridas a través de procesos de formación y reguladas en protocolos y normas oficiales, no pueden dejar de reconocer que las prácticas médicas cotidianas surgen y reproducen prácticas culturales locales, y de la cultura organizacional de los centros de salud donde trabajan (2).…”