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      Obstetric violence in the daily routine of care and its characteristics

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          ABSTRACT

          Objective:

          to analyze the scientific production on obstetric violence by identifying and discussing its main characteristics in the routine care for the pregnant-puerperal cycle.

          Method:

          integrative literature review of 24 publications indexed in the Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, SciVerse Scopus, Web of Science and the Scientific Electronic Library Online and Virtual Health Library.

          Results:

          the publications are intensified from 2015 onwards and present methodological designs of quantitative and qualitative nature. In the discussion, we first address the concept of obstetric violence and its different forms of occurrence in care. Then, interfaces of the phenomenon are presented with reflections related to the conception of gender, the different actors involved, the institutionalization, and the invisibility and trivialization of the event. Finally, strategies to combat the problem are presented through academic training, women’s awareness, proposals of social mobilization, and creation of public policies and laws.

          Conclusion:

          obstetric violence portrays a violation of human rights and a serious public health problem and is revealed in the form of negligent, reckless, omissive, discriminatory and disrespectful acts practiced by health professionals and legitimized by the symbolic relations of power that naturalize and trivialize their occurrence.

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          Most cited references36

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          Integrative review: what is it? How to do it?

          ABSTRACT Introduction: The integrative review is the methodology that provides synthesis of knowledge and applicability of results of significant studies to practice. Objective: To present the phases of an integrative review and the relevant aspects to be taken into account when using this methodological resource. Methods: This study was based on bibliographic search and on the experience of the authors when performing an integrative review. Results: Presentation of the six stages of the integrative review process: preparing the guiding question, searching or sampling the literature, data collection, critical analysis of the studies included, discussion of results and presentation of the integrative review. Conclusions: Considering the need to assure care based on scientific evidence, the integrative review has been identified as a unique tool in healthcare for it synthesizes investigations available on the given topic and guides practice based on scientific knowledge.
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            Moving beyond disrespect and abuse: addressing the structural dimensions of obstetric violence.

            During recent decades, a growing and preoccupying excess of medical interventions during childbirth, even in physiological and uncomplicated births, together with a concerning spread of abusive and disrespectful practices towards women during childbirth across the world, have been reported. Despite research and policy-making to address these problems, changing childbirth practices has proved to be difficult. We argue that the excessive rates of medical interventions and disrespect towards women during childbirth should be analysed as a consequence of structural violence, and that the concept of obstetric violence, as it is being used in Latin American childbirth activism and legal documents, might prove to be a useful tool for addressing structural violence in maternity care such as high intervention rates, non-consented care, disrespect and other abusive practices.
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              The effect of a multi-component intervention on disrespect and abuse during childbirth in Kenya

              Background Disrespect and abuse (D & A) during labor and delivery are important issues correlated with human rights, equity, and public health that also affect women’s decisions to deliver in facilities, which provide appropriate management of maternal and neonatal complications. Little is known about interventions aimed at lowering the frequency of disrespectful and abusive behaviors. Methods Between 2011 and 2014, a pre-and-post study measured D & A levels in a three-tiered intervention at 13 facilities in Kenya under the Heshima project. The intervention involved working with policymakers to encourage greater focus on D & A, training providers on respectful maternity care, and strengthening linkages between the facility and community for accountability and governance. At participating facilities, postpartum women were approached at discharge and asked to participate in the study; those who consented were administered a questionnaire on D & A in general as well as six typologies, including physical and verbal abuse, violations of confidentiality and privacy, detainment for non-payment, and abandonment. Observation of provider-patient interaction during labor was also conducted in the same facilities. In both exit interview and observational studies, multivariate analyses of risk factors for D & A controlled for differences in socio-demographic and facility characteristics between baseline and endline surveys. Results Overall D & A decreased from 20–13 % (p < 0.004) and among four of the six typologies D & A decreased from 40–50 %. Night shift deliveries were associated with greater verbal and physical abuse. Patient and infant detainment declined dramatically from 8.0–0.8 %, though this was partially attributable to the 2013 national free delivery care policy. Conclusion Although a number of contextual factors may have influenced these findings, the magnitude and consistency of the observed decreases suggest that the multi-component intervention may have the potential to reduce the frequency of D & A. Greater efforts are needed to develop stronger evaluation methods for assessing D & A in other settings.
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                Author and article information

                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                29 November 2018
                2018
                : 26
                : e3069
                Affiliations
                [1 ]Fundação Oswaldo Cruz, Centro de Pesquisas René Rachou, Belo Horizonte, MG, Brazil.
                [2 ]Hospital Sofia Feldman, Belo Horizonte, MG, Brazil.
                Author notes
                [Corresponding Author: ] Danúbia Mariane Barbosa Jardim E-mail: danubia.barbosaj@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-9671-5152
                Article
                00613
                10.1590/1518-8345.2450.3069
                6280177
                30517571
                f5274549-f271-4068-a223-9295e21a6dc8
                © 2018 Revista Latino-Americana de Enfermagem

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 01 October 2017
                : 14 August 2018
                Page count
                Figures: 15, Tables: 0, Equations: 0, References: 34, Pages: 1
                Categories
                Review Articles

                violence against women,women,obstetrics,delivery,exposure to violence,review

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