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The magnitude of the problem of obstetric violence and its associated factors: A cross-sectional study
Institution:1. Assistant Professor, Departamento de Antropología, Universidad de Chile, Santiago, Chile;2. Research Assistant, Instituto Universitário de Lisboa (ISCTE-IUL), CIES-IUL, Lisboa, Portugal;3. Assistant Professor on History of Science, Department of Surgery and Medical and Social Sciences, University of Alcalá, Alcalá de Henares, Spain;4. Assistant Professor, Escuela de Obstetricia y Puericultura, Universidad de Santiago de Chile, Santiago, Chile;5. Independent Researcher, Laboratorio Multimediale di Comparazione Giuridica, Dipartimento di Scienze Politiche, Università degli Studi “Roma TRE”, Unità di Ricerca “Diritti Umani nella Maternità e Nascita”, Roma, Italy;6. Head of Research and Development for Nurses, Midwives and AHPs, Southern Health and Social Care Trust, Belfast, United Kingdom; Lecturer, School of Nursing, Institute of Nursing and Health Sciences, Ulster University, Belfast;7. Senior Lecturer, Metropolitan University College, Copenhagen, Denmark
Abstract:BackgroundIn recent years, the concept of obstetric violence has become visible among women and professionals, but its prevalence and the factors with which it is related in our healthcare environment are unknown.AimTo determine the prevalence of obstetric violence in the Spanish healthcare system and identify the associated factors.MethodsA cross-sectional observational study was conducted during 2019 and included 899 women who had given birth in the last 12 months. An online questionnaire was distributed through midwives and women associations in Spain. The questionnaire included sociodemographic, clinical, and assistance practices variables. The primary outcome variable was obstetric violence and its verbal, physical, and psycho-affective types. Crude odds ratios (OR) and adjusted OR (ORa) were estimated using binary logistic regression.ResultsObstetric violence was reported by 67.4% (606) of the women; 25.1% (226) verbal, 54.5% (490) physical, and 36.7% (330) psycho-affective. Overall obstetric violence was observed more frequently in women who attended maternal education programme (ORa 1.56, 95% CI 1.05–2.32), those who presented a birth plan but it was not respected (ORa 2.82, 95% CI 1.27–6.29), those who received regional analgesia (ORa 1.61, 95% CI 1.13–2.30), those who required an urgent caesarean section (ORa 3.46, 95% CI 1.79–6.69), underwent an episiotomy (ORa 3.34, 95% CI 2.21–5.38), and whose newborn was admitted to an intensive care unit (ORa 2.73, 95% CI: 1.21–6.15). The presentation of a birth plan was observed as protective factors, and the possibility of skin-to-skin (ORa 0.34, 95% CI 0.18–0.62) and felt respected (ORa 0.61, 95% CI 0.43–0.85).ConclusionsTwo out of three women perceive having suffered obstetric violence during childbirth. Practices such as skin-to-skin contact, and the use of respected birth plans, were protective factors against obstetric violence.
Keywords:Obstetric violence  Birth  Woman  Pregnancy  Human rights
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