Exposing Obstetric Violence in the Eastern Mediterranean Region: A Review of Women's Narratives of Disrespect and Abuse in Childbirth.
Eastern Mediterranean
SRHR
childbirth
disrespect and abuse (D&A)
obstetric violence
respectful maternity care (RMC)
women-centered care
Journal
Frontiers in global women's health
ISSN: 2673-5059
Titre abrégé: Front Glob Womens Health
Pays: Switzerland
ID NLM: 101776281
Informations de publication
Date de publication:
2022
2022
Historique:
received:
08
01
2022
accepted:
07
03
2022
entrez:
13
5
2022
pubmed:
14
5
2022
medline:
14
5
2022
Statut:
epublish
Résumé
Obstetric violence (OV) threatens the provision of dignified, rights-based, high-quality, and respectful maternal care (RMC). The dearth of evidence on OV in the Eastern Mediterranean Region poses a knowledge gap requiring research to improve rights-based and respectful health practice and policy. While efforts to improve the quality of maternal health have long-existed, women's experiences of childbirth and perceptions of dignity and respect are not adequately or systematically recorded, especially in the said region. This study centered on the experiences of women's mistreatment in childbirth to provide an overview of OV and offer recommendations to improve RMC. A scoping review was conducted, and a total of 38 articles met the inclusion criteria and were analyzed using Bowser and Hill's framework of the seven typologies of Disrespect and Abuse (D&A) in childbirth. D&A in childbirth (or violations to RMC) is a manifestation of OV and served as a proxy to analyze its prevalence in the EMR. This study indicated that across the EMR, women experienced every type of D&A in childbirth. This happens regardless of health systems' strength or country's income, with 6 out of 7 types of D&A found in almost two-thirds of included countries. In the EMR, the most common types of D&A in childbirth are physical abuse (especially overused routine interventions) and non-dignified care (embedded in patriarchal socio-cultural norms). The intersections of these abuses enable the objectification of women's bodies and overuse of unconsented routine interventions in a hierarchical and patriarchal system that regards the power and autonomy of doctors above birthing women. If unchecked, the implications include acceptance, continuation, and underreporting of D&A in childbirth, as well as passivity toward human-rights violations, which all further cause the continuing the cycle of OV. In order to eliminate OV, a paradigm shift is required involving infrastructure changes, education, empowerment, advocacy, a women-centered and gender-sensitive approach to health system strengthening, and policy development. Recommendations are given at individual, community, health systems, and policy levels to ensure that every woman achieves her right to health and birth in a dignified, respectful, and empowered manner.
Sections du résumé
Background
UNASSIGNED
Obstetric violence (OV) threatens the provision of dignified, rights-based, high-quality, and respectful maternal care (RMC). The dearth of evidence on OV in the Eastern Mediterranean Region poses a knowledge gap requiring research to improve rights-based and respectful health practice and policy. While efforts to improve the quality of maternal health have long-existed, women's experiences of childbirth and perceptions of dignity and respect are not adequately or systematically recorded, especially in the said region.
Aim
UNASSIGNED
This study centered on the experiences of women's mistreatment in childbirth to provide an overview of OV and offer recommendations to improve RMC.
Methods
UNASSIGNED
A scoping review was conducted, and a total of 38 articles met the inclusion criteria and were analyzed using Bowser and Hill's framework of the seven typologies of Disrespect and Abuse (D&A) in childbirth. D&A in childbirth (or violations to RMC) is a manifestation of OV and served as a proxy to analyze its prevalence in the EMR.
Findings and Discussion
UNASSIGNED
This study indicated that across the EMR, women experienced every type of D&A in childbirth. This happens regardless of health systems' strength or country's income, with 6 out of 7 types of D&A found in almost two-thirds of included countries. In the EMR, the most common types of D&A in childbirth are physical abuse (especially overused routine interventions) and non-dignified care (embedded in patriarchal socio-cultural norms). The intersections of these abuses enable the objectification of women's bodies and overuse of unconsented routine interventions in a hierarchical and patriarchal system that regards the power and autonomy of doctors above birthing women. If unchecked, the implications include acceptance, continuation, and underreporting of D&A in childbirth, as well as passivity toward human-rights violations, which all further cause the continuing the cycle of OV.
Conclusion
UNASSIGNED
In order to eliminate OV, a paradigm shift is required involving infrastructure changes, education, empowerment, advocacy, a women-centered and gender-sensitive approach to health system strengthening, and policy development. Recommendations are given at individual, community, health systems, and policy levels to ensure that every woman achieves her right to health and birth in a dignified, respectful, and empowered manner.
Identifiants
pubmed: 35547827
doi: 10.3389/fgwh.2022.850796
pmc: PMC9082810
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
850796Informations de copyright
Copyright © 2022 Khalil, Carasso and Kabakian-Khasholian.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
BMC Pregnancy Childbirth. 2019 May 22;19(1):182
pubmed: 31117987
East Mediterr Health J. 2012 Jan;18(1):94-9
pubmed: 22360017
Health Care Women Int. 2013;34(6):499-512
pubmed: 23409814
Ann Saudi Med. 2013 Jan-Feb;33(1):28-33
pubmed: 23458937
Reprod Health. 2018 Feb 6;15(1):23
pubmed: 29409519
Women Birth. 2017 Feb;30(1):e39-e45
pubmed: 27692959
Int J Equity Health. 2017 Jul 7;16(1):121
pubmed: 28687082
PLoS One. 2018 Jul 11;13(7):e0200318
pubmed: 29995939
Lancet. 2016 Nov 5;388(10057):2307-2320
pubmed: 27642018
Int J Evid Based Healthc. 2011 Mar;9(1):25-31
pubmed: 21332660
BMC Pregnancy Childbirth. 2020 Jan 9;20(1):26
pubmed: 31918682
Midwifery. 2017 Oct;53:63-70
pubmed: 28763721
Int J Gynaecol Obstet. 2015 Oct;131 Suppl 1:S49-52
pubmed: 26433506
PLoS One. 2020 Mar 9;15(3):e0229941
pubmed: 32150593
BJOG. 2005 Sep;112(9):1270-6
pubmed: 16101607
Soc Sci Med. 2016 Nov;169:157-170
pubmed: 27723514
Reprod Health Matters. 2016 May;24(47):47-55
pubmed: 27578338
BMC Pregnancy Childbirth. 2018 Oct 24;18(1):415
pubmed: 30355293
BMC Pregnancy Childbirth. 2019 Oct 22;19(1):369
pubmed: 31640603
Lancet. 2018 Jun 30;391(10140):2642-2692
pubmed: 29753597
Reprod Health. 2015 Apr 16;12:33
pubmed: 25890317
Sex Reprod Health Matters. 2020 Dec;28(1):e1854153
pubmed: 33308051
Midwifery. 2018 Mar;58:71-76
pubmed: 29306737
Lancet. 2016 Oct 29;388(10056):2176-2192
pubmed: 27642019
Glob J Health Sci. 2014 May 08;6(5):46-54
pubmed: 25168980
Reprod Health Matters. 2017 Oct;25(sup1):16-26
pubmed: 29120285
Reprod Health. 2021 Oct 1;18(1):194
pubmed: 34598705
BMC Health Serv Res. 2013 May 06;13:166
pubmed: 23642217
BMC Pregnancy Childbirth. 2019 Nov 8;19(1):411
pubmed: 31703638
Reprod Health. 2017 Oct 11;14(1):127
pubmed: 29020966
BMC Pregnancy Childbirth. 2020 Mar 6;20(1):140
pubmed: 32138695
PLoS Med. 2015 Jun 30;12(6):e1001847; discussion e1001847
pubmed: 26126110
Lancet. 2019 Nov 9;394(10210):1750-1763
pubmed: 31604660
Rev Lat Am Enfermagem. 2018 Nov 29;26:e3069
pubmed: 30517571
Int Nurs Rev. 2014 Jun;61(2):278-84
pubmed: 24762171
BJOG. 2018 Jul;125(8):932-942
pubmed: 29117644
Midwifery. 2018 Apr;59:4-16
pubmed: 29351865
Reprod Health. 2020 Mar 9;17(1):35
pubmed: 32151284
Lancet Glob Health. 2019 Jan;7(1):e96-e109
pubmed: 30554766
Sex Reprod Healthc. 2010 Nov;1(4):129-34
pubmed: 21122611
Reprod Health. 2017 Mar 4;14(1):32
pubmed: 28259180
Midwifery. 2018 Apr;59:100-111
pubmed: 29421638
PLoS One. 2017 Jul 6;12(7):e0179702
pubmed: 28683112
Reprod Health Matters. 2016 May;24(47):65-73
pubmed: 27578340
Birth. 2019 Sep;46(3):500-508
pubmed: 30198111
J Egypt Public Health Assoc. 2015 Jun;90(2):64-71
pubmed: 26154833
Confl Health. 2015 Feb 02;9(1):S1
pubmed: 25685183
Int J Public Health. 2019 Dec;64(9):1291-1299
pubmed: 31673736
East Mediterr Health J. 2015 Oct 02;21(9):647-54
pubmed: 26450861
BMC Pregnancy Childbirth. 2013 Jan 24;13:21
pubmed: 23347548
BMC Pregnancy Childbirth. 2018 Aug 20;18(1):338
pubmed: 30126357
Midwifery. 2019 Jul;74:1-5
pubmed: 30908974
Lancet. 2019 Nov 9;394(10210):1692-1693
pubmed: 31604661
Midwifery. 2013 Nov;29(11):1251-6
pubmed: 23415357
Syst Rev. 2017 Jun 6;6(1):110
pubmed: 28587676
Reprod Health Matters. 2018;26(53):6-18
pubmed: 30189791
BMC Pregnancy Childbirth. 2019 Jan 22;19(1):39
pubmed: 30669981
Health Hum Rights. 2020 Jun;22(1):251-264
pubmed: 32669805
Health Res Policy Syst. 2018 Jul 6;16(1):58
pubmed: 29980230
Health Promot Perspect. 2014 Dec 30;4(2):137-43
pubmed: 25650105
BMC Pregnancy Childbirth. 2019 Aug 22;19(1):307
pubmed: 31443691
East Mediterr Health J. 2019 Nov 04;25(10):728-743
pubmed: 31774139