Disrespect and Abuse in Obstetric Care in Mexico: An Observational Study of Deliveries in Four Hospitals
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Disrespect and Abuse in Obstetric Care in Mexico: An Observational Study of Deliveries in Four Hospitals Alexander Brenes Monge1 · María Fernández Elorriaga1 · Ofelia Poblano Verástegui1 · Rosario Valdez Santiago2 · Manuel A. Martínez Nolasco1 · Iraís Yáñez Álvarez1 · Pedro J. Saturno Hernández1 Accepted: 6 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction To identify and describe the frequency and characteristics of disrespect and abuse practices towards women during facility-based delivery in four hospitals in two Mexican states in 2017, using a mixed method of direct observation and women’s reports of health care experiences. Methods A cross-sectional study was performed to describe disrespect and abuse practices in obstetric care (interactions or conditions that are experienced as or intended to be humiliating or undignified) committed by healthcare providers. We included all pregnant women admitted for childbirth (vaginal and cesarean). Semi-structured interviews were also conducted with women, prior to discharge, regarding their experience at delivery. Results 867 deliveries were observed. 18.8% of women (n = 163) experienced at least one disrespect and abuse event, especially at secondary care facilities. There were a total of 493 disrespect and abuse events, which, on average, represents three events per woman (39.4% were verbal abuse, 32% were physical abuse, and 28.6% were discrimination). In the majority of cases (> 50%), women did not give consent to not recommended invasive procedures and were not provided with adequate information to those procedures. Conclusions for Practice Direct observation and interviews was a useful tool to identify disrespectful and abusive practices during delivery care. Our findings provide new evidence of the frequency and characteristics of disrespect and abuse during delivery care in Mexico, which can be used to inform maternal health programs. Additionally, these results encourage the creation of surveillance policies and committees in order to guarantee violence-free and dignified treatment of women during delivery care. Keywords Abuse · Disrespect · Delivery · Childbirth · Mexico
Significance Staement What is already known on this subject? In Mexico, the prevalence of disrespect and abuse at delivery care have been reported in a range of 11% and 33.4%. Mexican women often Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10995-020-03052-9) contains supplementary material, which is available to authorized users. * María Fernández Elorriaga [email protected] 1
Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
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experience shouting, scolding, care delays, been ignored, pressure for contraceptive acceptance and non-consented contraception at delivery care. Disrespectful and abusive practic
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