Study reveals decrease in childbirth violence in Latvia

Writer: Elizabete Ārgale
(Gynaecologist, RSU Acting Researcher, doctoral student, Tutor, Department of Obstetrics and Gynaecology)

There are many studies in Europe and around the world on the medical outcomes of childbirth, but not so many on how women feel about childbirth and the support they receive. In 2021, a study* conducted by Rīga Stradiņš University (RSU) was released to the public for the first time to find out what mothers think and need during childbirth. The most widely debated aspect of the study was violence in childbirth.

One of the most widely discussed aspects of the study was obstetric violence. The study is ongoing and we can already draw the first conclusions: the incidence of violence has decreased significantly.

I am the coordinator of this World Health Organization (WHO) study in Latvia. In 2021, we surveyed and analysed the childbirth experiences of 2,000 women. The large number of respondents made it impossible for professionals in the field to ignore the findings, and Prof. Dace Rezeberga presented the results to the Ministry of Health of the Republic of Latvia. This allowed us to address aspects that influence the childbirth support environment. For example, we discussed midwives' salaries and work practices, such as reducing shift hours and improving working conditions.

In my opinion, raising awareness about childbirth support and childbirth-related violence has contributed to various educational initiatives. This has encouraged medical professionals to reflect on their practices and reconsider their approach.

That could be one of the reasons why the situation, at least based on the initial data, has improved significantly.

If previously, the percentage of women experiencing any form of violence during childbirth was 17% according to data from 2020–2021, it has now decreased to 5.2% (the latest figure covers the period from 2022 to the present, based on the responses of 1,610 participants analysed so far). 

How was violence defined in the survey? Let me explain. Participants were asked to indicate whether they had experienced any form of violence during childbirth — physical, verbal, or emotional. An example of physical violence mentioned in the survey included situations where a healthcare provider touched the woman inappropriately and/or without permission, or if she was pushed, slapped, punched, physically restrained, or choked. An example of verbal violence in the survey was if the woman was yelled at, insulted, or spoken to in a rude manner. Emotional violence was defined as being neglected, ridiculed, or forgotten by a healthcare professional. Further details were gathered to determine the specific type of violence a woman had experienced if she affirmed that violence had occurred.

Photo: Courtesy of Shutterstock.com

We are on the same level as the Scandinavian countries

We can compare the aspect of violence with other countries. As we can see, the situation has improved. In the first survey, the best results could be seen in the Scandinavian countries — around 8%. We are therefore now at the same level as the Scandinavian countries. However, data may change, and we plan to publish a full summary by the end of this year.

Comparatively, Poland and Lithuania have even better results. Of course, there are many factors that could influence this. A very low result could occur if respondents do not recognise or identify occurrences as violence.

Apart from the aspect of violence, we can also mention other indicators that have improved. The 2021 study showed that 63% of mothers had not received information about warning signs to look out for regarding their own health, and 75% had not received information about their child's health. At that time, I was shocked, because explaining what signs must not be ignored (for example, excessive bleeding, fever, shortness of breath, etc.) is one of the basic tasks of a doctor or midwife!

It is encouraging that these negative indicators have decreased significantly, meaning that healthcare professionals are increasingly doing work to educate their patients. Specifically, 40,39% of mothers have not received information about warning signs related to their own health, and 30% about their child's health. A significant improvement! If mothers know what to look out for, it helps reduce morbidity.

* The IMAgiNE EURO project (Improving MAternal Newborn carE In the EURO Region) is coordinated by the WHO collaboration center Istituto di Ricovero e Cura a Carattere Scientifico in Italy.

The full article in Latvian can be read on the LSM portal

Source: LSM.lv