Cameron, Flor de Abril
(2024)
A Quantitative Exploration of Latinx Childbearing People’s Experiences of Obstetric Violence and Respectful Maternity Care in the United States: A Secondary Analysis of the Giving Voices to Mothers Survey.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Obstetric violence (OV) refers to abuse or mistreatment by a health care provider or any invasive or surgical procedure performed without informed consent, that is coerced, or when procedures have been declined. OV stands in contrast to Respectful maternity care (RMC). This dissertation explores factors associated with OV and RMC and to what extent the intersectionality of nativity, parity, and history of social risk predict OV and RMC among Latinx childbearing people.
This is a secondary analysis of the Giving Voices to Mothers (GVtM) survey Latinx subsample which included 292 Latinx respondents across the United States. I employed logistic and linear regressions to assess relationships between socio-demographic variables obstetric characteristics intersectional composite variable and experiences of OV and RMC. A modified Mistreatment (MIST) index measured OV and the Mothers on Respect index (MORi) measured RMC. The intersectional composite consisted of all combinations of nativity, parity, and history of social risk.
Findings show that hospital births were significantly associated with greater likelihood of OV (OR=11.85) and lower MORi scores (Coeff = -6.74). A history of social risk also raised the odds of OV (OR=4.65). Lower MORi scores were associated with lack of support during labor (Coeff=-12.61), and operative/instrumental births (Coeff = -8). The intersectional composite variable, adjusting for delivery location, explains about 27% of the variation in respect scores and demonstrated a high level of discriminatory accuracy in predicting obstetric violence. However, it is not clear from this analysis which individual characteristic in the intersectional composite drives these effects.
This study confirms the role of the hospital environment in driving OV and impeding RMC, underscoring the need to address structural factors driving OV and RMC. These include, for example, re-thinking training for medical professionals, re-evaluating polices that contradict the tenets of RMC and creating accountability structures to address OV. This study also calls for ensuring access to different birthing models and support during labor and delivery. Lastly, this study demonstrates that an intersectional lens results in models with good predictive power for OV and RMC. Future studies should focus on marginalized identities and ensuring statistical power to thoroughly explore these phenomena.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
16 May 2024 |
| Date Type: |
Publication |
| Defense Date: |
23 April 2024 |
| Approval Date: |
16 May 2024 |
| Submission Date: |
25 April 2024 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
194 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Behavioral and Community Health Sciences |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
obstetric violence, respectful maternity care, mistreatment, Latinx health, Latino health, maternal health, reproductive health |
| Date Deposited: |
16 May 2024 17:47 |
| Last Modified: |
16 May 2024 17:47 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/46303 |
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