The birth of a new baby.
Should be an exciting time for any family.
Unfortunately,
that is not always the case.
Almost a third of new parents would describe their birth
as traumatic.
This is in large part due to something called obstetric violence
The World Health Organization has said,
every person has the right to the highest attainable standard
of care which includes the right to dignified respectful health
care throughout pregnancy and childbirth as well as the right
to be free from violence and discrimination.
This statement may sound like common sense to you,
but unfortunately it is not the reality for too many
birthing people.
Obstetric
violence is an umbrella term,
that covers any kind of abuse a pregnant person
may face while they are receiving care.
It is any kind of behavior that violates the person's
human rights,
legal rights, consent
bodily autonomy,
sexuality and dignity.
This type of abuse comes in many forms,
all of which are damaging to a birthing person.
Obstetric abuse,
can come from any care providers such as doctors.
Nurses anesthesiologist,
and even midwives.
It happens in all types of care facilities
He's from hospitals,
clinics breast centers and at home.
There are a wide range of behaviors.
That could be considered obstetric violence.
We're going to touch on a few hear the most
characteristic and noticeable.
Example of obstetric violence
is any kind of physical abuse towards the birthing person
moving from this,
there's also undignified care which includes things like verbal abuse
degradation and humiliation.
On top of this,
there is also non-consensual care,
which includes performing procedures,
like episiotomies and C-sections and the use of delivery instruments,
like forceps,
without the consent of the birthing person.
These are often done under threats of harm to the
patient or baby.
These forms are probably the most blatant forms of abuse
scene In obstetrics violence,
however,
this unfortunately is far from all of the forms of
obstetric violence can take. Things like non-confidential care,
which is what I provider collects patient information within earshot
of other patients.
And discrimination of any kind are both considered forms of
obstetric violence.
Lastly,
we have abandonment of care and attention in a facility.
Abandonment of care is when a care
provider for any reason to attend to one of their
patients or they fail to intervene in a life-threatening situation.
Detention in a facility occurs
when a birthing person is prevented from leaving the facility
They gave birth in or their baby is kept in
the facility for any non medical reason.
This reason is often failure to pay a bill, however, it is also used as a threat to
get birthing people to agree to unwanted interventions.
No matter what form it takes obstetric violence is a violation of basic human rights
and can have detrimental consequences on a birthing person,
and their family.
Experiencing obstetrics violence can have long-lasting negative effects.
People who've experienced obstetric violence report leaving their birth feeling
betrayed by their care providers.
Many had long-lasting trauma,
that required years of therapy and some experienced postpartum PTSD.
These breathing people describe being plagued with flashbacks and nightmares
of their birth, struggling with dissociation and feelings of being
brushed off by family and care providers
when they questioned what had happened?
Often times when people with PTSD reflect on their birth,
they experience heightened levels of anger,
depression and anxiety,
as well as isolation.
It is also not uncommon for parents who experienced a
traumatic birth to distance themselves from their new babies as
they become a trigger for their trauma.
This can understandably have a detrimental effect on the development
of a relationship with their baby.
Now that we know what obstetric violence is and it's
detrimental effects.
We must ask ourselves what can be done?
The best way to address
this issue is at the source,
the care providers.
Firstly addressing obstetrics violence,
during medical education will make future care providers aware of
the issue and how they can handle it to demonstrate this,
Let's look at a real-life example of a medical
student dealing with obstetric violence.
Paul was a fourth-year medical student,
who travel to another country for rotation
in Obstetrics & Gynecology.
Before arriving,
one of his friends warned him about the violence
he may encounter on the labour floor. This spurred Paul
to do some of his own research and he became
familiar with the term
Obstetric violence.
One day,
while he was working in the hospital
he witnessed a resident yelling at a patient who had
been pushing for hours.
He was threatening her with an episiotomy and a C-section.
All while degrading her,
and calling her weak for taking so long to deliver
her baby. Paul was horrified by this behaviour and immediately knew
it was wrong, however, he didn't know what he should do
On the one hand, he could have stepped up
right in the room and called the resident out on
their behavior since the resident was already hostile.
He was worried challenging him but only escalate the situation
and could make it worse for the patient.
Also,
He was not fully aware of the culture in this
country and he did not want to be culturally insensitive
and alternative to
this could have been to offer up supportive care for the woman
Research has shown that breathing people who receive supportive care.
I'm much less likely to experience mistreatment
This option would have been more likely to be viewed
favourably by the resident
As it would not have been directly criticizing the care.
He was providing. Another solution to this problem would be
institutional support for medical students.
They need to be better prepared for situations like this so
they are better able to identify cases of abuse and
want the best way to intervene is and how they
should report this behavior.
Now that we've looked at how to create better medical
professionals from the start,
what can existing medical professionals do to help combat this
issue to learn more about this.
We spoke to Kate Macdonald who's the founder of the
Obstetric Justice Project
And here's what she had to say. Medical professionals
should address obstetric violence by taking ownership over
the fact that they are participating in obstetric violence and
are complicit In obstetrics violence,
whether they intend to cause harm or not.
We cannot end obstetric violence,
unless medical professions recognize the issue,
call one another in and stop doing it.
It will take self-reflection,
letting go of defensiveness and ego,
discomfort,
and courage to stand
up and say that something is not right,
especially when all of their training has conditioned them to
believe that the current reality of care is normal and acceptable
All in all medical professionals need to hold themselves accountable
and educate themselves to be able to make the critical
changes necessary to end obstetric violence.
Now that we talked about what medical professionals can do.
Let's take some time and talk about some actions that
others can take to work towards ending obstetric violence in
2015,
the World Health Organization released a statement
which detailed steps that could be taken to end obstetric violence globally
First.
We need greater support for research from governments and other
development Partners.
More research is needed.
In order to measure the prevalence of this abuse,
as well as understanding the effects on birthing people.
This could lead to better implementation of more effective interventions.
They also suggest implementation of programs designed to better obstetric care
These types of programs with support care providers in changing their behaviour
the clinical environment and health systems to ensure birthing people
are receiving respectful,
quality obstetric care. Going along with this,
they recommend that there needs to be more emphasis on
the rights of the birthing person
to dignified and respectful care.
Advocacy in this area will help bring awareness to help
ensure all obstetric
care is meeting the human rights standard. Next, they
talk about professional support and ensuring that all care providers,
receive support,
and training to make sure that they are giving quality care
Finally, they discuss how the process for ending obstetric violence
must be inclusive
There are a number of organizations that exist to provide
helpful information to Aid,
both pregnant people and medical professionals.
These resources include the Obstetric Justice Project,
Birth Trauma Ontario
and evidence-based birth.
Evidence-based
birth is a company that has its mission set on
global health initiatives,
working to help birth workers gain
helpful skills,
and evidence-based practices needed to protect birth
givers the group provides accurate information to empower the prenatal
birth and postpartum experience for braiding people.
They provide free online articles,
podcasts,
and classes,
which aid in the childbearing process.
And I also offer resources for birthing professionals such as
continuing education classes regarding providing evidence-based care.
The Obstetric Justice Project is a Canadian company and
a patient advocacy
initiative working to address obstetric violence across Canada
They provide a safe space for patients families and professionals
to share their experiences with obstetric violence as well.
As a directory of where to direct complaints and reports
of obstetric violence in Canada.
They offer peer support for those working towards filing.
A complaint as well as workshops for clinical education events
Birth Trauma Ontario
advocates for birthing families and professionals working towards bringing systemic
change to the obstetric care system.
They offer private Facebook group for survivors of obstetric violence
to share experiences and help break the isolation that is
so often felt
they offer information on the rights of birthing parents,
as well as childbirth education.
So parents are able to go into birth to make
informed decisions. For both professionals,
they offer evidence-based information.
On providing trauma-informed care and breaking the cycle of obstetric
violence. On top of this,
They offer a professional course on trauma-informed care. At the end
of this course,
I person will have knowledge of what defines,
a traumatic birth,
postpartum PTSD
obstetric violence,
and more.
Upon completion.
They receive a certificate of completion and will be able
to take their new found knowledge and use it in their practice
This video is only the tip of the iceberg.
Please check out some of the resources linked in the
description to learn more about obstetric violence and advocacy against it
I hope you've learned something that you didn't know before
and will take this knowledge and help work towards ending
obstetric violence for good.
Thank you.