Social inequalities in women exposed to obstetric and gyneco-obstetric violence in Ecuador: a cross-sectional study

Abstract

Background Obstetric and gyneco-obstetric violence (OV, GOV) is a concerning public health problem, particularly in Latin America. This study aimed to determine the prevalence of OV and GOV and to assess its socio-geographical distribution in Ecuador. Methods This cross-sectional study used data from a national survey conducted in 2019 (n = 17,211) among women aged 15 years and over. Independent variables included age, marital status, education, ethnicity, place of residence and region. The chosen outcomes were lifetime experience of OV and GOV. Frequency tables were calculated and crude and adjusted regression models estimating prevalence ratios and their 95% confidence intervals were computed. Results Nearly one-third (32.8%) of the participants had experienced OV and two-fifths (41.86%) GOV at least once in their lifetime. Prevalence of OV were particularly common in women 26–35 and 46–55 years old, with primary or middle education and in urban regions. In comparison, GOV had a higher prevalence in women aged > 65 years and with no formal education. Both subtypes of violence were more common among women with current or earlier partners compared with the single ones. Also the two outcomes were more prevalent in the non-white population, OV among the populations of colour (POC), while GOV both, in the POC and Indigenous group. Additionally, women from the Highlands and Amazon reported higher OV and GOV than the Coastal group. Conclusion Our study showed that OV and GOV are common in Ecuador and identified an unequal distribution of their prevalence across different socio-geographical groups. Further studies including more social factors and a continuous monitoring of OV and GOV are recommended. Current policies, laws to protect women and guidelines regarding the treatment of women, particularly in health care settings, need to be constantly advocated for and effectively implemented in the country.

Unveiling the intersection: exploring obstetric violence in the Era of COVID-19 in Ecuador

“…The prevalence of obstetric violence in this study was of 73.6, much higher than the reported by other authors in the country before COVID-19 infection [ 8 – 11 ]. There are no scientific published data of this indicator during the pandemic.…”

“…All of them were violated in their rights to have a presence or supportive care during the hospitalization. This shocking result is a far cry from previous findings that one-third of women in Ecuador had experienced OV and two-fifths had experienced obstetric and gynaecological violence [ 8 ]. This finding would reinforce the thesis that the pandemic situation exacerbated obstetric violence [ 14 ].…”

“…Due to the COVID-19 outbreak, there are limits and interventions being introduced in birth that were unnecessary, unsupported by science, disrespectful of human dignity, and out of proportion to the goal of stopping the virus’s spread. They consequently constitute obstetric violence and include pointless procedures carried out against medical care [ 8 ].…”

“…In Ecuador according to Arias, approximately one-third (32.8%) of the studied subjects had encountered obstetric violence [ 8 ]. Other studies in the country have shown high figures of obstetric violence in its different aspects [ 9 , 10 ].…”

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

“…Regarding the living environment, previous literature has found obstetric violence to be common among rural communities in Mexico [ 29 , 51 ]; however, our results found a higher prevalence among urban populations. A study done in Ecuador also found a higher prevalence of obstetric violence among women living in urban areas [ 52 ]. Further research is required to better understand how different social inequities lead to obstetric violence against women in Mexico or to address the possibility of women from rural or Indigenous populations underreporting this type of violence in ENDIREH.…”