Obstetric Violence: An Undocumented and Unreported Epidemic
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Obstetric Violence: An Undocumented and Unreported Epidemic

obstetric-violence-an-undocumented-andunreported-epidemic

Obstetric Violence refers to any form of mistreatment, abuse, or disrespect experienced by women during pregnancy, childbirth, or the postpartum period. This can encompass various acts perpetrated by healthcare professionals, such as verbal and physical abuse, unnecessary medical procedures, or denial of care which violate a woman’s rights, autonomy, and dignity during the maternal healthcare process.

A traumatic childbirth experience can result in both short- and long-term health and well-being consequences for the woman and her family. The psychological impact can range from post-partum acute stress disorder (ASD), post-traumatic stress disorder (PTSD), and post-partum depression (PPD).

The Global Context

The term “obstetric violence” originated in Latin America, particularly in countries like Venezuela and Argentina around 2007. Women’s rights activists began using it to highlight the mistreatment experienced by women during childbirth. It gained international recognition as a human rights issue, drawing attention to the need for respectful maternity care worldwide.

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A multi-country study by the World Health Organization (WHO) included over 2,000 women in 15 different healthcare facilities across Ghana, Guinea, Myanmar, and Nigeria. It revealed that 42% ofv. This includes actions like slapping, pinching, and shouting. A study published in The Lancet in 2020 highlighted that 15.6% of women experienced abuse during childbirth in II European countries.

The Situation in India

Violence against labouring women in India is a common phenomenon. In the labour room, when women are in their most vulnerable state, they are yelled at, pinched, slapped, and blamed for crying aloud or making a scene.This violence is so prevalent and internalised by women that they don’t see the need to complain or protest. The Lancet, reported nearly 1 in 3 women in India experienced mistreatment during childbirth.

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Though India has made progress in reducing maternal mortality, it still faces challenges. As per the Sample Registration System (SRS), the Maternal Mortality Ratio (MMR) in India was 113 per 100,000 live births in 2016. The Center for Reproductive Rights and White Ribbon Alliance revealed that 31% of women surveyed in Uttar Pradesh, India, reported physical abuse during childbirth. Unfortunately, these figures represent reported cases, and there are likely many unreported incidents.

The Causes of Obstetric Violence

Three primary factors contributing to the widespread occurrence of Obstetric Violence in India and around the world are:

  • Stigmatisation and discriminatory practices
  • Inadequate adherence to professional care standards
  • Shortage of skilled birth attendants

Childbirth is often seen through the lens of class, culture, and social, and gender dynamics that can contribute to mistreatment. These factors create an environment where women’s voices may be suppressed, and their autonomy and consent may be disregarded. There is a pressing need for comprehensive training of healthcare professionals.

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Thirdly, there is an acute shortage of skilled birth attendants particularly midwives, as they play a vital role in protecting the rights of pregnant and labouring mothers. At present many countries are facing a shortage of skilled midwives. WHO estimates that globally, there is a shortage of 900,000 midwives, nurse-midwives, and midwifery associates.

Midwifery – A Solution that Works

Studies have shown that midwifery-led care can reduce maternal mortality by up to 25%. Midwives provide essential care to expectant mothers, offering guidance, monitoring health, and assisting in childbirth. They prioritise safe, respectful, and patient-centred care, ensuring that childbirth is a positive and healthy experience for both mother and baby. They are experts in recognising and managing normal pregnancies and births, reducing the need for medical interventions when not necessary.

Beyond birth, midwives also provide postpartum care, addressing the physical Investing in midwifery will go a long way in ensuring women receive positive, evidence-based, and respectful care. Emotional support provided by midwives for women can protect against a potentially negative birth experience, irrespective of the level of medical intervention.

Related: Understanding Postpartum Depression: Navigating the emotional journey of Motherhood

A collaborative effort is crucial to reforming India’s health system and eliminating obstetric violence. Thereby improving maternal and neonatal outcomes and promoting respectful and dignified childbirth experiences and the emotional well-being of mothers. Thereby contributing significantly to maternal and neonatal health outcomes. Their expertise and compassionate approach make them essential members of the healthcare team, helping to reduce maternal and infant mortality rates worldwide.

The solution to mitigate obstetric violence in India involves a multi-pronged approach. The need for comprehensive training of healthcare professionals to ensure they understand and respect the principles of informed consent and bodily autonomy is essential. Promoting community awareness and education about the rights of pregnant women and encouraging them to report instances of obstetric violence, can help create a culture of accountability. Ensuring access to quality healthcare services, particularly in underserved regions, will play a pivotal role in reducing instances of obstetric violence.

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