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Abstract
Background: since the second half of the 20th century, the principle of autonomy and a dignified treatment in health arises in the discourses of bioethics, human and women’s rights. The concept of obstetric violence questions the medicalization of childbirth given the decreased autonomy of women in the process. The problem has been addressed by international organizations, and in 2008 the Chilean Ministry of Health disseminated a Personalized Reproductive Care Manual. A decade later, some progress is observed, although public controversy continues. It is expected that this review will contribute to the debate to advance the proposed model.
Objectives: to describe and systematize the perceptions around obstetric violence and humanized childbirth of the different actors and stakeholders involved.
Methods: we employed a qualitative approach, complementing a systematic review with documental analysis of the written discourses representing perspectives of institutions, associations and social actors. The search period ranged from 2000 to 2018. The review consulted electronic resources, databases and electronic journals (BEIC, BIREME, Cochrane, DIALNET, EBSCO, WOS, REDALYC, IBECS, LILACS, MEDLINE, Elsevier, Wiley and SciELO). Search terms included ‘obstetric violence’, ‘humanized delivery’ and associated concepts. Additionally, we manually searched resources on the websites of former mentioned stakeholders.
Results: we included 33 documents, representing studies from different regions of Chile, as well as specialized reference texts. We performed analyses of discourses on seven laws, and on statements from a scientific society, two health associations, three ministries, and two non-government organizations. We will present a detailed description at the Colloquium. The dimensions that we identified were: type and practices of childbirth; caesareans and strategies to reduce their unwarranted practice; consumer preference and satisfaction; evaluations of the impact of introducing the new guidelines; the impact of prenatal education strategies; an emerging protagonist role of mothers; perceptions and attitudes of health professionals and consumers; historical-cultural construction of childbirth; women’s and birthing rights; obstetric training; socioeconomic and institutional health system; and precariousness of the public health system.
Conclusions: we observed difficulties in the application of the guidelines in the delivery of obstetric care, in the face of increasing requests from women. An analysis of the discourse of stakeholders reveals areas of consensus and areas of conflict. This broad strategy, involving various sources and a variety of analytical techniques, contributed to understanding the problem and identifying aspects to be addressed in order to advance towards the recommendations in light of the values and preferences of women.
Patient or healthcare consumer involvement: the study included neither of them.
Objectives: to describe and systematize the perceptions around obstetric violence and humanized childbirth of the different actors and stakeholders involved.
Methods: we employed a qualitative approach, complementing a systematic review with documental analysis of the written discourses representing perspectives of institutions, associations and social actors. The search period ranged from 2000 to 2018. The review consulted electronic resources, databases and electronic journals (BEIC, BIREME, Cochrane, DIALNET, EBSCO, WOS, REDALYC, IBECS, LILACS, MEDLINE, Elsevier, Wiley and SciELO). Search terms included ‘obstetric violence’, ‘humanized delivery’ and associated concepts. Additionally, we manually searched resources on the websites of former mentioned stakeholders.
Results: we included 33 documents, representing studies from different regions of Chile, as well as specialized reference texts. We performed analyses of discourses on seven laws, and on statements from a scientific society, two health associations, three ministries, and two non-government organizations. We will present a detailed description at the Colloquium. The dimensions that we identified were: type and practices of childbirth; caesareans and strategies to reduce their unwarranted practice; consumer preference and satisfaction; evaluations of the impact of introducing the new guidelines; the impact of prenatal education strategies; an emerging protagonist role of mothers; perceptions and attitudes of health professionals and consumers; historical-cultural construction of childbirth; women’s and birthing rights; obstetric training; socioeconomic and institutional health system; and precariousness of the public health system.
Conclusions: we observed difficulties in the application of the guidelines in the delivery of obstetric care, in the face of increasing requests from women. An analysis of the discourse of stakeholders reveals areas of consensus and areas of conflict. This broad strategy, involving various sources and a variety of analytical techniques, contributed to understanding the problem and identifying aspects to be addressed in order to advance towards the recommendations in light of the values and preferences of women.
Patient or healthcare consumer involvement: the study included neither of them.
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