Components of obstetric violence in health facilities in Quito, Ecuador: A descriptive study on information, accompaniment, and position during childbirth.

OBJECTIVE: To describe three factors of obstetric violence in health centers that attend births in Quito, Ecuador: information; accompaniment; and free position. METHOD: A cross-sectional descriptive study of 388 women was conducted, focusing on the analysis of three factors of obstetric violence. This study forms part of a larger study that explores the experiences of women in childbirth in Quito between July 1, 2016 and July 1, 2017. RESULTS: Of all procedures, the performance of episiotomies and the application of fundal pressure during the second stage of labor (Kristeller) stand out, as more than 35% of the women were not informed about them. In total, 121 (46.9%) women who gave birth vaginally were not given the opportunity to be accompanied by someone of their choice, neither in labor nor during delivery. While in the cases of cesarean deliveries, this increased to 116 (92.1%) women. A total of 119 (37.2%) women did not have the opportunity to choose their birthing position (or they did not know they could choose). During delivery, 138 (53.5%) women indicated the same. CONCLUSION: Obstetric violence is seen in all three components: information; accompaniment; and free position.

Childbirth experiences related to obstetric violence in public health units in Quito, Ecuador.

OBJECTIVE: To explore women's experiences of obstetric violence related to childbirth in Ecuador. METHODS: The present cross-sectional descriptive study combined qualitative and quantitative elements of women's childbirth experience in Quito, Ecuador, between July 1, 2016, and July 1, 2017. Women who delivered in public health units providing different levels of care completed a survey of 32 questions, divided into six dimensions of obstetric violence. RESULTS: Overall, 388 women completed the survey, of whom 259 (66.8%) delivered vaginally and 129 (33.2%) delivered by cesarean. Among 120 women who delivered for the first time, 62 (51.7%) had an episiotomy. At the second stage of labor, uterine fundus pressure (Kristeller maneuver) was performed for 49 (19.4%) of 252 women. Overall, 196 (50.5%) women reported that they were not allowed to engage in early attachment, and 135 (34.8%) reported that they did not receive support for the initiation of breastfeeding. CONCLUSION: Various forms of obstetric violence are occurring in the public health services of Quito, despite World Health Organization recognition of the need for perinatal care at the highest level. Programs designed to prevent and diminish obstetric violence are urgently required.