Breastfeeding and Obstetric Violence during the SARS-CoV-2 Pandemic in Spain: Maternal Perceptions
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Šimonović, D. A Human Rights-Based Approach to Mistreatment and Violence against Women in Reproductive Health Services with a Focus on Childbirth and Obstetric Violence; The United Nations: New York, NY, USA, 2019.
- Pérez D’gregorio, R. Obstetric violence: A new legal term introduced in Venezuela. Int. J. Gynecol. Obstet. 2010, 111, 201–202. [Google Scholar] [CrossRef] [PubMed]
- Quattrocchi, P. Obstetric Violence Observatory: Contributions of Argentina to the International Debate. Med. Anthropol. Cross Cult. Stud. Health Illn. 2019, 38, 762–776. [Google Scholar] [CrossRef] [PubMed]
- Comunidad Autónoma de Cataluña Ley 17/2020, de 22 de Diciembre, de Modificación de la Ley 5/2008, del Derecho de las Mujeres a Erradicar la Violencia Machista 2020, 18. Available online: https://www.boe.es/buscar/doc.php?id=BOE-A-2021-464 (accessed on 20 October 2022).
- Sadler, M.; Leiva, G.; Olza, I. COVID-19 as a risk factor for obstetric violence. Sex. Reprod. Health Matters 2020, 28, 1–3. [Google Scholar] [CrossRef] [PubMed]
- Kotlar, B.; Gerson, E.; Petrillo, S.; Langer, A.; Tiemeier, H. The impact of the COVID-19 pandemic on maternal and perinatal health: A scoping review. Reprod. Health 2021, 18, 10. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Home Care for Patients with COVID-19 Presenting with Mild Symptoms and Management of Contacts: Interim Guidance; World Health Organization: Geneva, Switzerland, 2020.
- Fox, A.; Marino, J.; Amanat, F.; Krammer, F.; Hahn-Holbrook, J.; Zolla-Pazner, S.; Powell, R.L. Robust and Specific Secretory IgA Against SARS-CoV-2 Detected in Human Milk. iScience 2020, 23, 101735. [Google Scholar] [CrossRef]
- Coxon, K.; Turienzo, C.F.; Kweekel, L.; Goodarzi, B.; Brigante, L.; Simon, A.; Lanau, M.M. The impact of the coronavirus (COVID-19) pandemic on maternity care in Europe. Midwifery 2020, 88, 102779. [Google Scholar] [CrossRef] [PubMed]
- Beck, C.T. Middle Range Theory of Traumatic Childbirth: The Ever-Widening Ripple Effect. Glob. Qual. Nurs. Res. 2015, 2, 2333393615575313. [Google Scholar] [CrossRef] [PubMed]
- Beck, C.T.; Watson, S. Impact of Birth Trauma on Breast-feeding. Nurs. Res. 2008, 57, 228–236. [Google Scholar] [CrossRef] [PubMed]
- Coates, R.; Ayers, S.; de Visser, R. Women’s experiences of postnatal distress: A qualitative study. BMC Pregnancy Childbirth 2014, 14, 1–14. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Diamond, R.M.; Colaianni, A. The impact of perinatal healthcare changes on birth trauma during COVID-19. Women Birth 2022, 35, 503–510. [Google Scholar] [CrossRef] [PubMed]
- Mena-Tudela, D.; Iglesias-Casás, S.; González-Chordá, V.M.; Cervera-Gasch, A.; Andreu-Pejó, L.; Valero-Chilleron, M.J. Obstetric Violence in Spain (Part I): Women’s Perception and Interterritorial Differences. Int. J. Environ. Res. Public Health 2020, 17, 7726. [Google Scholar] [CrossRef] [PubMed]
- Mena-Tudela, D.; Iglesias-Casás, S.; González-Chordá, V.M.; Cervera-Gascch, Á.; Andreu-Pejó, L.; Valero-Chilleron, M.J. Obstetric Violence in Spain (Part II): Interventionism and Medicalization during Birth. Int. J. Environ. Res. Public Health 2021, 18, 199. [Google Scholar] [CrossRef] [PubMed]
- Mena-Tudela, D.; Iglesias-Casás, S.; González-Chordá, V.M.; Valero-Chilleron, M.J.; Andreu-Pejó, L.; Cervera-Gasch, Á. Obstetric Violence in Spain (Part III): Healthcare Professionals, Times, and Areas. Int. J. Environ. Res. Public Health 2021, 18, 3359. [Google Scholar] [CrossRef] [PubMed]
- Mena-Tudela, D.; Aguilar-Camprubí, L.; Quifer-Rada, P.; Paricio-Talayero, J.M.; Padró-Arocas, A. The COVID-19 vaccine in women: Decisions, data and gender gap. Nurs. Inq. 2021, 28, e12416. [Google Scholar] [CrossRef]
- Selma-Royo, M.; Bäuerl, C.; Mena-Tudela, D.; Aguilar-Camprubí, L.; Pérez-Cano, F.J.; Parra-Llorca, A.; Lerin, C.; Martínez-Costa, C.; Collado, M.C. Anti-SARS-CoV-2 IgA and IgG in human milk after vaccination is dependent on vaccine type and previous SARS-CoV-2 exposure: A longitudinal study. Genome Med. 2022, 14, 42. [Google Scholar] [CrossRef] [PubMed]
- Batista, C.L.C.; Ribeiro, V.S.; Nascimento, M.d.D.S.B.; Rodrigues, V.P. Association between pacifier use and bottle-feeding and unfavorable behaviors during breastfeeding. J. Pediatr. (Rio. J.) 2018, 94, 596–601. [Google Scholar] [CrossRef]
- Chang, Y.S.; Beake, S.; Kam, J.; Lok, K.Y.W.; Bick, D. Views and experiences of women, peer supporters and healthcare professionals on breastfeeding peer support: A systematic review of qualitative studies. Midwifery 2022, 108, 103299. [Google Scholar] [CrossRef] [PubMed]
- Tranche Iparraguirre, S.; Martín Álvarez, R.; Párraga Martínez, I.; Grupo colaborativo de la Junta Permanente y Directiva de la semFYCd. El reto de la pandemia de la COVID-19 para la Atención Primaria. Rev. Clínica Med. Fam. 2021, 14, 85–92. [Google Scholar]
- Koleilat, M.; Whaley, S.E.; Clapp, C. The Impact of COVID-19 on Breastfeeding Rates in a Low-Income Population. Breastfedding Med. 2022, 17, 33–37. [Google Scholar] [CrossRef]
- Dennis, C.L.; Shiri, R.; Brown, H.K.; Santos, H.P.; Schmied, V.; Falah-Hassani, K. Breastfeeding rates in immigrant and non-immigrant women: A systematic review and meta-analysis. Matern. Child Nutr. 2019, 15, 1–15. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Gunes, A.O.; Dincer, E.; Karadag, N.; Topcuoglu, S.; Karatekin, G. Effects of COVID-19 pandemic on breastfeeding rates in a neonatal intensive care unit. J. Perinat. Med. 2021, 49, 500–505. [Google Scholar] [CrossRef] [PubMed]
- Marín Gabriel, M.A.; Manchado Perero, S.; Manzanares Gutiérrez, L.; Martín Lozoya, S.; Gómez de Olea Abad, B. COVID-19 infection in childbirth and exclusive breastfeeding rates in a BFHI maternity. An. Pediatría, 2022; in press. [Google Scholar] [CrossRef] [PubMed]
- Brown, A.; Shenker, N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Matern. Child Nutr. 2021, 17e, e13088. [Google Scholar] [CrossRef] [PubMed]
- Rice, K.; Williams, S. Women’s postpartum experiences in Canada during the COVID-19 pandemic: A qualitative study. C. Open 2021, 9, E556–E562. [Google Scholar] [CrossRef]
- Gallego, I.R.; Vilchez, H.S.; Cano, I.A.; Sánchez, C.M.; Dolores, M.; Giraldo, S.; Fernández, C.G.; Guisado, C.B.; Larios, F.L. Breastfeeding experiences during the COVID-19 pandemic in Spain: A qualitative study. Int. Breastfeed. J. 2022, 17, 11. [Google Scholar] [CrossRef] [PubMed]
- Quifer-Rada, P.; Aguilar-Camprubí, L.; Padró-Arocas, A.; Gómez-Sebastià, I.; Mena-Tudela, D. Impact of COVID-19 Pandemic in Breastfeeding Consultations on LactApp, an m-Health Solution for Breastfeeding Support. Telemed. J. e-Health. 2022, 28, 1449–1457. [Google Scholar] [CrossRef] [PubMed]
- Jardim, D.M.B.; Modena, C.M. Obstetric violence in the daily routine of care and its characteristics. Rev. Lat. Am. Enfermagem 2018, 26, e3069. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Khalil, M.; Carasso, K.B.; Kabakian-khasholian, T. Exposing Obstetric Violence in the Eastern Mediterranean Region: A Review of Women’s Narratives of Disrespect and Abuse in Childbirth. Front. Glob. Women’s Health 2022, 3, 850796. [Google Scholar] [CrossRef]
- Bohren, M.A.; Mehrtash, H.; Fawole, B.; Maung, T.M.; Balde, M.D.; Maya, E.; Thwin, S.S.; Aderoba, A.K.; Vogel, J.P.; Irinyenikan, T.A.; et al. How women are treated during facility-based childbirth in four countries: A cross-sectional study with labour observations and community-based surveys. Lancet 2019, 394, 1750–1763. [Google Scholar] [CrossRef][Green Version]
- Janevic, T.; Maru, S.; Nowlin, S.; McCarthy, K.; Bergink, V.; Stone, J.; Dias, J.; Wu, S.; Howell, E.A. Pandemic Birthing: Childbirth Satisfaction, Perceived Health Care Bias, and Postpartum Health During the COVID-19 Pandemic. Matern. Child Health J. 2021, 25, 860–869. [Google Scholar] [CrossRef] [PubMed]
- de Oliveira Ribeiro, D.; Calgagno Gomes, G.; Netto de Oliveira, A.M.; Quadros Alvarez, S.; Goulart Gonçalves, B.; Ferreira Acosta, D. Obstetric violence in the perception of multiparous women. Rev. Gaúcha Enferm. 2020, 41, e20190419. [Google Scholar] [CrossRef] [PubMed]
- Solnes Miltenburg, A.; van Pelt, S.; Meguid, T.; Sundby, J. Disrespect and abuse in maternity care: Individual consequences of structural violence. Reprod. Health Matters 2018, 26, 88–106. [Google Scholar] [CrossRef] [PubMed]
- Rodríguez Mir, J.; Martínez Gandolfi, A. Obstetric violence. A hidden practice in medical care in Spain. Gac. Sanit. 2021, 35, 211–212. [Google Scholar] [CrossRef] [PubMed]
- Shrivastava, S.; Sivakami, M. Evidence of “obstetric violence” in India: An integrative review. J. Biosoc. Sci. 2020, 52, 610–628. [Google Scholar] [CrossRef]
- Vidal-Coso, E.; Miret-Gamundi, P. Characteristics of First-time Parents in Spain along the 21st Century. Rev. Española Investig. Sociol. 2017, 160, 115–138. [Google Scholar] [CrossRef]
n (%) | |
---|---|
Occupation | |
Housewife | 279 (4.6) |
Student | 55 (0.9) |
Unemployed | 579 (9.6) |
Employed worker | 4423 (73) |
Self-employed | 586 (9.7) |
Other | 138 (2.3) |
Level of education | |
Basic education | 60 (1) |
Secondary education | 1264 (20.9) |
University education | 4736 (78.2) |
Social class | |
Lower | 260 (4.3) |
Middle | 5664 (93.5) |
Upper | 136 (2.2) |
Race or ethnicity | |
Caucasian | 5887 (97.1) |
Romani | 8 (0.1) |
Black | 11 (0.2) |
Other | 103 (1.7) |
Type of childbirth | |
Caesarean section | 1309 (21.6) |
Scheduled C-section | 395 (30.18) |
Urgent C-section | 914 (69.82) |
Instrumental birth | 869 (14.3) |
Vaginal birth | 3882 (64.1) |
Type of healthcare | |
Private healthcare | 584 (9.6) |
Public healthcare | 3572 (58.9) |
Mixed healthcare | 1904 (31.4) |
Maternal SARS-CoV-2 | |
No | 5797 (95.7) |
Yes, during pregnancy | 200 (3.3) |
Yes, during childbirth | 63 (1) |
Neonatal SARS-CoV-2 (n = 263) | |
No | 255 (97) |
Yes | 8 (3) |
n (%) | |
---|---|
During the postpartum period, did you feel supported in your decisions about feeding and caring for your baby? | |
No | 1590 (27.5) |
Yes | 3951 (68.3) |
Do not know | 246 (4.3) |
In which area did you feel unsupported? (n = 1590) | |
Primary care | 381 (24.0) |
Hospital | 1046 (65.8) |
Both in primary care and in hospital | 163 (2.7) |
Offered formula feeding to help her rest or because she did not have enough milk | |
No | 3920 (69.3) |
Yes | 1536 (27.2) |
Do not know | 198 (3.5) |
Were you put in contact with support groups in the area? | |
No | 4315 (76.3) |
Yes | 1140 (20.1) |
Do not know | 204 (3.6) |
Did you feel effectively supported and helped to resolve doubts or difficulties? | |
No | 1819 (32.5) |
Yes | 3783 (67.5) |
Were you advised to stop breastfeeding so that you could be vaccinated against COVID-19? | |
No | 5034 (90.6) |
Yes | 88 (1.6) |
Do not know | 437 (7.9) |
Would you say you have experienced obstetric violence? | |
No | 4030 (66.5) |
Yes | 1578 (26.0) |
Do not know | 452 (7.5) |
Obstetric violence is justified by the pandemic (n = 1578) | |
No | 1376 (87.2) |
Yes | 57 (3.6) |
Do not know | 145 (9.2) |
Obstetric Violence | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Total | No | Do Not Know | Yes | ||||||||
n | % | n | % | n | % | n | % | X2 | df1 | p2 | |
During the postpartum period, did you feel supported in your decisions about feeding and caring for your baby? | |||||||||||
No | 1590 | 27.5 | 765 | 19.7 | 170 | 40.5 | 655 | 44.4 | 404.941 | 4 | <0.001 |
Do not know | 246 | 4.3 | 140 | 3.6 | 25 | 6.0 | 81 | 5.5 | |||
Yes | 3951 | 68.3 | 2988 | 76.8 | 225 | 53.6 | 738 | 50.1 | |||
In which area did you feel unsupported? (n = 1590) | |||||||||||
Primary care | 381 | 24.0 | 236 | 30.8 | 36 | 21.2 | 109 | 16.6 | 42.339 | 4 | <0.001 |
Hospital | 1046 | 65.8 | 459 | 60.0 | 121 | 71.2 | 466 | 71.1 | |||
Both | 163 | 10.3 | 70 | 9.2 | 13 | 7.6 | 80 | 12.2 | |||
Offered formula feeding to help her rest or because she did not have enough milk | |||||||||||
No | 3920 | 69.3 | 2802 | 73.8 | 249 | 60.3 | 869 | 60.3 | 119.467 | 4 | <0.001 |
Do not know | 98 | 3.5 | 123 | 3.2 | 27 | 6.5 | 48 | 3.3 | |||
Yes | 1536 | 27.2 | 487 | 23.0 | 137 | 33.2 | 525 | 36.4 | |||
Were you put in contact with support groups in the area? | |||||||||||
No | 4315 | 76.3 | 2745 | 72.3 | 342 | 82.6 | 1228 | 84.9 | 108.864 | 4 | <0.001 |
Do not know | 204 | 3.6 | 151 | 4.0 | 20 | 4.8 | 33 | 2.3 | |||
Yes | 1140 | 20.1 | 902 | 23.7 | 52 | 12.6 | 186 | 12.9 | |||
Did you feel effectively supported and helped to resolve doubts or difficulties? | |||||||||||
No | 1819 | 32.5 | 969 | 25.8 | 185 | 45.5 | 665 | 46.4 | 235.522 | 2 | <0.001 |
Yes | 3783 | 67.5 | 2793 | 74.2 | 222 | 54.5 | 768 | 53.6 | |||
Were you advised to stop breastfeeding so that you could be vaccinated against COVID-19? | |||||||||||
No | 5034 | 90.6 | 3441 | 92.2 | 347 | 85.5 | 1246 | 88.1 | 32.940 | 4 | <0.001 |
Do not know | 437 | 7.9 | 252 | 6.7 | 47 | 11.6 | 138 | 9.8 | |||
Yes | 88 | 1.6 | 46 | 1.2 | 12 | 3.0 | 30 | 2.1 |
Maternal SARS-CoV-2 | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Total | No | Yes, during Pregnancy | Yes, during Childbirth | ||||||||
n | % | n | % | n | % | n | % | X2 | df1 | p2 | |
During the postpartum period, did you feel supported in your decisions about feeding and caring for your baby? | |||||||||||
No | 1590 | 27.5 | 1520 | 27.5 | 45 | 23.6 | 25 | 39.7 | 7.313 | 4 | 0.129 |
Do not know | 246 | 4.3 | 238 | 4.3 | 7 | 3.7 | 1 | 1.6 | |||
Yes | 3951 | 68.3 | 3775 | 68.2 | 139 | 72.8 | 37 | 58.7 | |||
In which area did you feel unsupported? (n = 1590) | |||||||||||
Primary care | 381 | 24.0 | 362 | 23.8 | 16 | 35.6 | 3 | 12.0 | 6.697 | 4 | 0.153 |
Hospital | 1046 | 65.8 | 999 | 65.7 | 27 | 60.0 | 20 | 80.0 | |||
Both | 163 | 10.3 | 159 | 10.5 | 2 | 4.4 | 2 | 8.0 | |||
Offered formula feeding to help her rest or because she did not have enough milk | |||||||||||
No | 3920 | 69.3 | 3747 | 69.3 | 137 | 73.3 | 36 | 58.1 | 5.358 | 4 | 0.252 |
Do not know | 198 | 3.5 | 188 | 3.5 | 7 | 3.7 | 3 | 4.8 | |||
Yes | 1536 | 27.2 | 1470 | 27.2 | 43 | 23.0 | 23 | 37.1 | |||
Were you put in contact with support groups in the area? | |||||||||||
No | 4315 | 76.3 | 4126 | 76.3 | 140 | 74.5 | 49 | 79.0 | 0.895 | 4 | 0.925 |
Do not know | 204 | 3.6 | 196 | 3.6 | 6 | 3.2 | 2 | 3.2 | |||
Yes | 1140 | 20.1 | 1087 | 20.1 | 42 | 22.3 | 11 | 17.7 | |||
Did you feel effectively supported and helped to resolve doubts or difficulties? | |||||||||||
No | 1819 | 32.2 | 1733 | 32.4 | 57 | 30.6 | 29 | 46.8 | 6.093 | 2 | 0.048 |
Yes | 3783 | 67.5 | 3621 | 67.6 | 129 | 69.4 | 33 | 53.2 | |||
Were you advised to stop breastfeeding so that you could be vaccinated against COVID-19? | |||||||||||
No | 5034 | 90.6 | 4819 | 90.7 | 164 | 88.2 | 51 | 85.0 | 4.075 | 4 | 0.396 |
Do not know | 437 | 7.9 | 410 | 7.7 | 19 | 10.2 | 8 | 13.3 | |||
Yes | 88 | 1.6 | 84 | 1.6 | 3 | 1.6 | 1 | 1.7 |
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Mena-Tudela, D.; Iglesias-Casas, S.; Cervera-Gasch, A.; Andreu-Pejó, L.; González-Chordá, V.M.; Valero-Chillerón, M.J. Breastfeeding and Obstetric Violence during the SARS-CoV-2 Pandemic in Spain: Maternal Perceptions. Int. J. Environ. Res. Public Health 2022, 19, 15737. https://doi.org/10.3390/ijerph192315737
Mena-Tudela D, Iglesias-Casas S, Cervera-Gasch A, Andreu-Pejó L, González-Chordá VM, Valero-Chillerón MJ. Breastfeeding and Obstetric Violence during the SARS-CoV-2 Pandemic in Spain: Maternal Perceptions. International Journal of Environmental Research and Public Health. 2022; 19(23):15737. https://doi.org/10.3390/ijerph192315737
Chicago/Turabian StyleMena-Tudela, Desirée, Susana Iglesias-Casas, Agueda Cervera-Gasch, Laura Andreu-Pejó, Victor Manuel González-Chordá, and María Jesús Valero-Chillerón. 2022. "Breastfeeding and Obstetric Violence during the SARS-CoV-2 Pandemic in Spain: Maternal Perceptions" International Journal of Environmental Research and Public Health 19, no. 23: 15737. https://doi.org/10.3390/ijerph192315737