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Breaking the silence about obstetric violence: body mapping women’s narratives of respect, disrespect and abuse during childbirth in Bihar, India

Breaking the silence about obstetric violence: body mapping women’s narratives of respect, disrespect and abuse during childbirth in Bihar, India
Breaking the silence about obstetric violence: body mapping women’s narratives of respect, disrespect and abuse during childbirth in Bihar, India
Background: evidence on obstetric violence is reported globally. In India, research shows that almost every woman goes through some level of disrespect and abuse during childbirth, more so in states such as Bihar where over 70% of women give birth in hospitals.

Objective: 1) To understand how women experience and attach meaning to respect, disrespect and abuse during childbirth; and 2) document women’s expectations of respectful care.

Methods: ‘Body mapping’, an arts-based participatory method, was applied. The analysis is based on in-depth interviews with eight women who participated in the body mapping exercise at their homes in urban slums and rural villages. Analysis was guided by feminist relational discourse analysis.

Findings: women reported their experiences of birthing at home, public facilities, and private hospitals in simple terms of what they felt ‘good’ and ‘bad’. Good experiences included being spoken to nicely, respecting privacy, companion of choice, a bed to rest, timely care, lesser interventions, obtaining consent for vaginal examination and cesarean section, and better communication. Bad experiences included unconsented interventions including multiple vaginal examinations by different care providers, unanesthetized episiotomy, repairs and uterine exploration, verbal, physical, sexual abuse, extortion, detention and lack of privacy.

Discussion: the body maps capturing birth experiences, created through a participatory method, accurately portray women’s respectful and disrespectful births and are useful to understand women’s experience of a sensitive issue in a patriarchal culture. An in-depth understanding of women’s choices, experiences and expectations can inform changes practices in and policies and help to develop a culture of sharing birth experiences.
Attitude of Health Personnel, Cesarean Section, Delivery, Obstetric, Female, Humans, Parturition, Pregnancy, Violence
1471-2393
19
Mayra, Kaveri
f4fcac6b-f7c0-412f-8201-ea75ff51b722
Sandall, Jane
133e0210-256a-4aaf-8a1d-fd2aec7e03dc
Matthews, Zoë
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Padmadas, Sabu S.
64b6ab89-152b-48a3-838b-e9167964b508
Mayra, Kaveri
f4fcac6b-f7c0-412f-8201-ea75ff51b722
Sandall, Jane
133e0210-256a-4aaf-8a1d-fd2aec7e03dc
Matthews, Zoë
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Padmadas, Sabu S.
64b6ab89-152b-48a3-838b-e9167964b508

Mayra, Kaveri, Sandall, Jane, Matthews, Zoë and Padmadas, Sabu S. (2022) Breaking the silence about obstetric violence: body mapping women’s narratives of respect, disrespect and abuse during childbirth in Bihar, India. BMC Pregnancy and Childbirth, 22 (1), 19, [318]. (doi:10.1186/s12884-022-04503-7).

Record type: Article

Abstract

Background: evidence on obstetric violence is reported globally. In India, research shows that almost every woman goes through some level of disrespect and abuse during childbirth, more so in states such as Bihar where over 70% of women give birth in hospitals.

Objective: 1) To understand how women experience and attach meaning to respect, disrespect and abuse during childbirth; and 2) document women’s expectations of respectful care.

Methods: ‘Body mapping’, an arts-based participatory method, was applied. The analysis is based on in-depth interviews with eight women who participated in the body mapping exercise at their homes in urban slums and rural villages. Analysis was guided by feminist relational discourse analysis.

Findings: women reported their experiences of birthing at home, public facilities, and private hospitals in simple terms of what they felt ‘good’ and ‘bad’. Good experiences included being spoken to nicely, respecting privacy, companion of choice, a bed to rest, timely care, lesser interventions, obtaining consent for vaginal examination and cesarean section, and better communication. Bad experiences included unconsented interventions including multiple vaginal examinations by different care providers, unanesthetized episiotomy, repairs and uterine exploration, verbal, physical, sexual abuse, extortion, detention and lack of privacy.

Discussion: the body maps capturing birth experiences, created through a participatory method, accurately portray women’s respectful and disrespectful births and are useful to understand women’s experience of a sensitive issue in a patriarchal culture. An in-depth understanding of women’s choices, experiences and expectations can inform changes practices in and policies and help to develop a culture of sharing birth experiences.

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Accepted/In Press date: 1 February 2022
e-pub ahead of print date: 14 April 2022
Additional Information: © 2022. The Author(s).
Keywords: Attitude of Health Personnel, Cesarean Section, Delivery, Obstetric, Female, Humans, Parturition, Pregnancy, Violence

Identifiers

Local EPrints ID: 456964
URI: http://eprints.soton.ac.uk/id/eprint/456964
ISSN: 1471-2393
PURE UUID: 813bcecd-ab92-4c35-aa3e-c88e7b2a8cee
ORCID for Zoë Matthews: ORCID iD orcid.org/0000-0003-1533-6618
ORCID for Sabu S. Padmadas: ORCID iD orcid.org/0000-0002-6538-9374

Catalogue record

Date deposited: 18 May 2022 16:55
Last modified: 30 Oct 2023 02:46

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Contributors

Author: Kaveri Mayra
Author: Jane Sandall
Author: Zoë Matthews ORCID iD

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