Understanding the opinion of doctors on obstetric violence in Brazil to improve women's care

Abstract

Background: Disrespect and mistreatment in childbirth are human rights violations and must be understood by everyone. However, there are many controversies in the use of the term 'obstetric violence' in Brazil. Objectives: To understand the opinion of residents and specialist doctors about obstetric violence and get a balanced view to improve women's care. Setting: Public university hospital in São Paulo, Brazil. Participants: Residents in training and specialist doctors in obstetrics and gynecology. Measurements: Participants answered an electronic form on obstetric violence opinions. Findings: Of the 60 participants, 33(45%) were specialist doctors and 27(55%) were medical residents in training. Most interviewees (60%) do not agree with the use of the term “obstetric violence” to define mistreatment and disrespectful treatment of women. Regarding situations that characterize obstetric violence, the percentage of residents who agree with the following statements as forms of obstetric violence was significantly (p<0.05) higher than the specialists in the following aspects: episiotomy without consent (78% vs. 15%), episiotomy without indication (100% vs. 64%), episiotomy without anesthesia (96% vs. 76%), not allowing a companion during childbirth (89% vs. 64%), requiring silence from the birthing woman (100% vs. 73%), undergoing vaginal examinations without consent (85% vs. 58%), not allowing the woman to choose childbirth position (82% vs. 58%) and not allowing breastfeeding in the first hour (82% vs. 58%). Conclusions and implications: The resident doctors in training are aware that the Obstetric Violence typifies the mistreatment and abuse of women during childbirth and the same is not true for specialists. Specialist doctors who completed their training longer ago should undergo training programs for a better understanding of Obstetric Violence.