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Multistakeholder perspectives on the mistreatment of indigenous women during childbirth in Colombia: drivers and points for intervention

BACKGROUND: Abusive and disrespectful treatment of women during childbirth is a critical global issue that threatens women’s sexual rights and reproductive rights and access to quality maternal care. This phenomenon has been documented in Colombia. However, little emphasis has been placed on identif...

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Autores principales: Gleason, Emily Gaffney, López Ríos, Jennifer Marcela, Molina Berrío, Diana Patricia, Mejía Merino, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8917769/
https://www.ncbi.nlm.nih.gov/pubmed/35277129
http://dx.doi.org/10.1186/s12884-022-04495-4
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author Gleason, Emily Gaffney
López Ríos, Jennifer Marcela
Molina Berrío, Diana Patricia
Mejía Merino, Cristina
author_facet Gleason, Emily Gaffney
López Ríos, Jennifer Marcela
Molina Berrío, Diana Patricia
Mejía Merino, Cristina
author_sort Gleason, Emily Gaffney
collection PubMed
description BACKGROUND: Abusive and disrespectful treatment of women during childbirth is a critical global issue that threatens women’s sexual rights and reproductive rights and access to quality maternal care. This phenomenon has been documented in Colombia. However, little emphasis has been placed on identifying the drivers of and potential interventions against disrespect and abuse against particularly vulnerable populations in the country, including internally displaced indigenous women. METHODS: This report is a sub-analysis of a larger project. Semi-structured interviews were conducted with indigenous (Embera) women with childbirth experience (n = 10), maternal healthcare workers (n = 6), and community stakeholders (n = 5) in Medellín, Colombia. Qualitative analysis techniques, consisting of inductive and deductive approaches, were used to identify and characterize the drivers of disrespect and abuse against indigenous women during childbirth and points for intervention. Existing frameworks were adapted to thematically organize drivers and potential solutions into four interrelated subsystems: individual and community factors, clinician factors, facility factors, and national health system factors. RESULTS: Participants highlighted disrespect and abuse as stemming from (within the individual and community level) its normalization, lack of autonomy and empowerment among indigenous women, lacking antenatal care, (within the clinician level) prejudice, linguistic or cultural barriers to communication, lack of understanding of indigenous culture, medical culture and training, burnout and demoralization, (within the facility level) inadequate infrastructure, space, and human resources, and (within the national systems level) lack of clear policies and the devaluing of respectful maternity care. They called for interventions specific to these drivers, grounded in dignity and respect for indigenous culture. CONCLUSION: This paper expands upon the growing literature on global mistreatment during childbirth by highlighting drivers of mistreatment and identifying points for intervention in a previously unstudied population. Our data show that indigenous women are especially vulnerable to mistreatment due to cultural and linguistic barriers and prejudice. Broad and meaningful action is urgently needed to realize these women’s rights to respectful maternity care. Interventions must be multifaceted and locally specific, taking into account the needs and wants of the women they serve. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-022-04495-4.
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spelling pubmed-89177692022-03-21 Multistakeholder perspectives on the mistreatment of indigenous women during childbirth in Colombia: drivers and points for intervention Gleason, Emily Gaffney López Ríos, Jennifer Marcela Molina Berrío, Diana Patricia Mejía Merino, Cristina BMC Pregnancy Childbirth Research BACKGROUND: Abusive and disrespectful treatment of women during childbirth is a critical global issue that threatens women’s sexual rights and reproductive rights and access to quality maternal care. This phenomenon has been documented in Colombia. However, little emphasis has been placed on identifying the drivers of and potential interventions against disrespect and abuse against particularly vulnerable populations in the country, including internally displaced indigenous women. METHODS: This report is a sub-analysis of a larger project. Semi-structured interviews were conducted with indigenous (Embera) women with childbirth experience (n = 10), maternal healthcare workers (n = 6), and community stakeholders (n = 5) in Medellín, Colombia. Qualitative analysis techniques, consisting of inductive and deductive approaches, were used to identify and characterize the drivers of disrespect and abuse against indigenous women during childbirth and points for intervention. Existing frameworks were adapted to thematically organize drivers and potential solutions into four interrelated subsystems: individual and community factors, clinician factors, facility factors, and national health system factors. RESULTS: Participants highlighted disrespect and abuse as stemming from (within the individual and community level) its normalization, lack of autonomy and empowerment among indigenous women, lacking antenatal care, (within the clinician level) prejudice, linguistic or cultural barriers to communication, lack of understanding of indigenous culture, medical culture and training, burnout and demoralization, (within the facility level) inadequate infrastructure, space, and human resources, and (within the national systems level) lack of clear policies and the devaluing of respectful maternity care. They called for interventions specific to these drivers, grounded in dignity and respect for indigenous culture. CONCLUSION: This paper expands upon the growing literature on global mistreatment during childbirth by highlighting drivers of mistreatment and identifying points for intervention in a previously unstudied population. Our data show that indigenous women are especially vulnerable to mistreatment due to cultural and linguistic barriers and prejudice. Broad and meaningful action is urgently needed to realize these women’s rights to respectful maternity care. Interventions must be multifaceted and locally specific, taking into account the needs and wants of the women they serve. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-022-04495-4. BioMed Central 2022-03-11 /pmc/articles/PMC8917769/ /pubmed/35277129 http://dx.doi.org/10.1186/s12884-022-04495-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Gleason, Emily Gaffney
López Ríos, Jennifer Marcela
Molina Berrío, Diana Patricia
Mejía Merino, Cristina
Multistakeholder perspectives on the mistreatment of indigenous women during childbirth in Colombia: drivers and points for intervention
title Multistakeholder perspectives on the mistreatment of indigenous women during childbirth in Colombia: drivers and points for intervention
title_full Multistakeholder perspectives on the mistreatment of indigenous women during childbirth in Colombia: drivers and points for intervention
title_fullStr Multistakeholder perspectives on the mistreatment of indigenous women during childbirth in Colombia: drivers and points for intervention
title_full_unstemmed Multistakeholder perspectives on the mistreatment of indigenous women during childbirth in Colombia: drivers and points for intervention
title_short Multistakeholder perspectives on the mistreatment of indigenous women during childbirth in Colombia: drivers and points for intervention
title_sort multistakeholder perspectives on the mistreatment of indigenous women during childbirth in colombia: drivers and points for intervention
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8917769/
https://www.ncbi.nlm.nih.gov/pubmed/35277129
http://dx.doi.org/10.1186/s12884-022-04495-4
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