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Description
Obstetric Violence (OV) violates the reproductive health rights of persons at any time during pregnancy, birth, or post-partum and denies autonomy and decision making in their reproductive health care. In the past few decades qualitative researchers have identified OV as gendered violence throughout Latin America and legislation on OV has been introduced throughout the region. Epidemiological studies conducted within this framework have measured the magnitude of this phenomenon and have made comparisons between factors that are associated with an increased risk of OV. In 2016, the household survey ENDIREH (Encuesta Nacional sobre la Dinámica de las Relaciones en los Hogares) surveyed 142,363 households on gender violence, with girls and women ages 15 and older as the target population. The current study looked at the association between OV encountered in IMSS clinics and hospitals and geographic region. OV was categorized into two different outcomes, violence and abuse and non-consented care. Logistic regression analyses evaluated factors associated with the likelihood of OV at childbirth in IMSS clinics and hospitals, and the differences between different Mexican regions (North, Central, Central West, Southeast). Among the final sample (n=6,657), 34.32% reported having experienced at least one form of OV within the previous five years, with OV- abuse and violence reported at 26.78% and OV- nonconsented care at 16.94%. In the final logistic regression model, controlling for age, education, and residential area, the odds of OV were 1.257 (CI 1.074, 1.471) times higher among women in the Central region compared to women in the North region. Similarly, the odds of OV were 1.276 (CI 1.121, 1.453) times higher among women in Central West regions compared to their northern counterparts. IMSS facilities having the highest proportion of OV nationally, with risk of OV varying by geographic region, indicates sociogeographic implications in the provision of IMSS services. This study did not include analysis of the overmedicalization of childbirth or racialized treatment in IMSS facilities due to the limited scope of the ENDIREH 2016 Survey. Evidence based protocols are needed to disrupt OV by establishing what respectful obstetric care is and how it should be provided to parturient patients.
