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Abstract
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A growing body of scientific evidence followed by clinical recommendations illustrates that a physiological birth embedded into a positive birth experience is crucial (WHO, 2016, 2018). At the same time, evidence of disrespect, mistreatment, and abuse of childbearing women is increasing (Freedman et al., 2014; Bohren et al., 2015; Miller and Lalonde, 2015; WHO, 2014; Baranowska et al., 2019; Skoko and Battisti, 2017; Mena-Tudela et al., 2020).1 These behaviours are subsumed under the terms "obstetric violence" and "disrespect and abuse in childbirth" (Pérez D'Gregorio, 2010; Freedman et al., 2014).
Tensions between the supportive and disrespectful care during labour and birth can be observed in midwifery education. Midwifery educational programmes focus on evidence-based theoretical and clinical education as well as the midwifery philosophy of care (ICM, 2019). Midwifery students are initially taught all the physiological processes. During the second academic year they are introduced to more complex situations during childbirth (ICM, 2019; Thompson et al., 2019; WHO, 2019). However, many students perceive a gap between their acquired knowledge and their observations on labour wards (Moyer et al., 2016; Thompson et al., 2019).
Violence during childbirth can take many forms, including inappropriate use of interventions and medicalisation, as well as poor communication patterns (Bohren et al., 2015). Each of these can influence the experiences of childbearing women during labour (Pérez D'Gregorio, 2010; Bohren et al., 2015; WHO, 2018). Based on Bohren's typology (Bohren et al., 2015), different forms of violence towards childbearing women are observed during labour and birth. The typology was developed to enable the quantitative analysis of mistreatment during childbirth worldwide and refers to seven main themes: physical, sexual, and verbal abuse; stigma and discrimination; failure to meet professional standards of care; poor rapport between childbearing women and providers; healthcare system conditions and constraints. Various forms of violence during childbirth can be perpetrated by different people, and differences between professional groups have indeed been found in existing studies of violence (Bohren et al., 2015).
Language: en |