Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE credits
Background: The World Health Organization (WHO) has acknowledged that a lot of women in the world experience obstetric violence during childbirth in health institutions, and called on countries to step up efforts in the prevention and elimination of these human rights violations. The organization advocated for more research activities to be done to clarify the definition of obstetric violence. The aim of this study is, therefore, to analyze the concept of “obstetric violence during childbirth” from a midwifery perspective.
Methods: The hybrid model by Schwartz-Barcott and Kim was used for this concept analysis, which consists of theoretical, fieldwork and synthesis phases. For the theoretical phase, an electronic literature review was employed. Literature written in English and published from 2010 to 2021 was included. For the field study phase, 12 midwives in The Gambia and Sweden were interviewed and data were analyzed inductively by thematic content analysis. In the synthesis phase, the results of the theoretical and fieldwork phase were combined and analyzed.
Results: Obstetric violence during childbirth was defined as “a state of physical, psychological and structural violence as well as non-confidential care of a woman during childbirth which increases the tendency of, intentional or unintentional, inflicting unnecessary pain, with lack of privacy and dignity by a caregiver or a midwife”. Four main themes emerged, namely; physical violence (including withholding pain relief), psychological violence (including non-consented care, non-dignified care, discriminatory care, abandonment of care, and verbal abuse), structural violence, and non-confidential care.
Conclusion: Obstetric violence can be defined as a concept including four interlinked dimensions, with structural obstetric violence being the underlying form influencing the other three forms; psychological violence, physical violence, and non-confidential care.
Clinical implications: This study contributes with a new definition of the term “obstetric violence”. The findings indicate that obstetric violence during childbirth exists in both countries and can occur without the midwives being aware. Therefore, there is a need for the designing of proper supervision, training, policies as well as interventions that will promote knowledge and respectful maternity care.
2022.