«Birth is an event with strong emotional, psychological and affective implications on the mother and the child. It is essential that, for each birth, an appropriate level of obstetric assistance and care attentive to the physical and mental needs of the mother and her newborn is guaranteed”. Valeria underlines it Fiorenza Perris, Psychotherapist and Clinical Director of the online psychology service and Benefit Society You bravo. «Giving birth to a child is a unique and intense experience. Precisely for this reason, no mother should be denied the right to experience such an important moment according to her own way of being and feeling».
According to the expert, «it is essential to promote a culture of birth that is more aware, respectful and designed for the needs of each woman. In fact, if, on the one hand, medicalization and health protocols have contributed to reducing the incidence of complications, absolutely desirable especially in the presence of risk factors, on the other, registering childbirth within a standardized routine risks emptying such an extraordinary event of its uniqueness and deepest meaning».
Still too often childbirth is, in fact, managed according to a serial approach. «Its dehumanization – explains the expert – is frequently a direct consequence of the shortage of medical and nursing personnel: a problem that afflicts Italy and many other countries in the world. Upon their entry into the hospital habitat, theand women stop being considered as individuals and are subjected to standard procedures, sometimes invasive, unnecessary or even harmful. When situations of violation of human rights occur, such as excessive medicalization, the administration of treatments or drugs without consent or the lack of respect for the person and his will, we can speak of obstetric violence ».
Obstetric violence is also leaving women alone after childbirth
«Loneliness after childbirth can also be considered a form of obstetric violence». Very often, in fact, mothers are left completely alone from the first moments after giving birth, without anyone regularly checking their physical or psychological health conditions and that of the newborn. “The loneliness of women in childbirth and postpartum is a very widespread problem, as also confirmed by recent scientific studies, including the one conducted by theBurlo Garofalo Institute of Trieste, WHO Collaborating Center for Maternal and Child Health. From the survey, which examined a sample of almost 5,000 women who gave birth to a child between March 2020 and February 2021, in the toughest months of the pandemic, it emerged that: 78.4% could not receive assistance from their partner, 39.2% did not feel completely involved in medical choices, 24.8% did not always feel treated with dignity, while 12.7% said even to have been abused».
According to the World Health Organization, assistance during the final stages of pregnancy and the first days of the baby’s life is essential. Unfortunately, reality instead gives us many, many stories of loneliness, abandonment and suffering. An example of this is what happened at the Pertini hospital in Rome, where a newborn baby died suffocated in the arms of his mother who, left alone and exhausted after 17 hours of labor, fell asleep while she was breastfeeding him. The news story, which took place at the beginning of this year, brought the issue of obstetric violence once again to the attention of the public and the media.
Following the incident, MamaChatthe first European body for chat help dedicated to victims of violence, has launched a petition on the Change.org platform to guarantee 24-hour access to carers during childbirth and throughout the period of hospitalization of mother and child.
However, opening the doors of the wards to partners and family members is only a first step. Loneliness is not only the one you feel immediately after giving birth to a child, but also the one you know after returning home. The frailties that follow the moment of childbirth are many, which is why it is necessary to implement even more post-natal support measures.
Consequences of obstetric violence on the health of mother and child
In the weeks following childbirth, up to 85% of mothers experience a mild and temporary form of anxiety depression called maternity blues. Others know, however, the postpartum depressiona more serious but less common condition, although it may affect up to 1 in 5 women.
Although studies are still not widespread, research conducted in recent years has found a close correlation between episodes of obstetric violence and the occurrence of postpartum depression. First of all, it has been observed that the psychological well-being of women after childbirth is profoundly influenced by the conditions in which the birth itself took place and by the quality of the support received from hospital and family personnel.
«Obstetric violence exposes women to multiple risk factors. In fact, a difficult or bloody birth can have many consequences on the psychophysical health of the mother, with repercussions also on the well-being of the child. Having experienced a trauma in such a unique, delicate and full of expectations moment can exponentially increase the chances of developing postpartum depression or lead to the onset of post-traumatic stress disorder. Furthermore, there could be manifestations of anxiety and panic or dysfunctional behaviors», explains Perris. “Trauma can also aggravate pre-existing conditions or act as a trigger for disorders such as anorexia, bipolar disorder, obsessive-compulsive disorder and substance abuse. Furthermore, it is very common for women who are victims of episodes of obstetric violence to develop feelings of anger, devaluation and self-blame for having been impotent and failing to protect their own rights and those of their child. In the most serious cases, the psychic and emotional instability caused by the trauma could even invalidate the woman’s ability to take care of the newborn and compromise the creation of an empathetic relationship between mother and child. Finally, it is not uncommon for women to develop a sense of rejection of motherhood to the point of leading some of them to deny themselves the possibility of having more children. Protecting mothers therefore means protecting the new generations and our future».
Obstetric violence in Italy
In Italy, it is only in recent years that mothers have begun to make their voices heard and denounce. “This delay is attributable to the fact that, in very many cases, the women themselves have had difficulty in becoming aware of the problem of obstetric violence and in realizing that they have been victims of it,” observes Perris. «This is above all due to the legacy, still widespread in our culture, which sees the suffering of the parturient as something to be praised and glorified and which means that, in the delivery room, any form of expropriation of the rights over the body to the detriment of the mother is considered normal and widely legitimate».
The 2016 social media campaign brought the theme of obstetric violence to the attention of the public and the Italian media for the first time #EnoughShut up mothers have a voice. For two weeks, women were invited to share their childbirth experience on a blank sheet of paper, then photograph it and post it on the campaign page. With thousands of testimonies collected, the initiative has ensured that, finally, even in Italy a chorus of voices was raised on the theme of aesthetic violence.
In the wake of the social initiative it was then born OVO Italythe Observatory on Midwifery Violence, a civil society body, managed by mothers, which carries out important research, data collection and dissemination activities on the subject.
In 2017, OVOItalia commissioned a survey to Doxa that could provide an exhaustive picture of obstetric violence in our country. The study involved a sample of around 5 million Italian women, aged between 18 and 54, with at least one child aged 0-14. The results of the survey, later made public in an article in theEuropean Journal of Obstetrics & Gynecology, have unearthed a very alarming photograph. 21% of the women interviewed said they had suffered abuse or violence during their first birth experience. Over 4 out of 10 women have been the victim of practices harmful to their psychophysical dignity. 54% of pregnant women said they had undergone an episiotomy, a very invasive operation and not recommended by the WHO as it is harmful and damaging, to which 61% said they never gave their informed consent. When performed “treacherously” or without anesthesia, episiotomy, which involves the surgical cutting of the vagina and perineum, can have very serious consequences on a woman’s sexuality and mental health. Also according to the study, 6% of those interviewed said they no longer wanted children and that they had given up on a second pregnancy due to the traumatic experience they had had. Other women, on the other hand, after having experienced a bloody birth, complained of difficulty in breastfeeding. All of this obviously has very strong social consequences. In fact, there is talk of over 20,000 unborn children every year.
Perinatal psychology: a precious support to the psychophysical well-being of mother and child
«In Italy, although the phenomenon is still little known and there is no real legislation on the subject, it is not uncommon for cases of obstetric violence to occur. However, precisely because of the consequences that these traumatic episodes can have on the health of mothers and their children, it is essential that a widespread awareness of the phenomenon is created. The first step to eliminate this form of violence is to ensure that women acquire greater awareness of their rights and that they are put in a position to recognize the alarm bells of this phenomenon and, above all, are not afraid to make their voices heard and report, if necessary”, concluded Dr. Valeria Fiorenza Perris.
«Becoming a mother is a unique and extraordinary experience. However, together with joy, uncertainties, doubts and fears can also emerge. To better enjoy motherhood it is important, first of all, to inform yourself and prepare yourself adequately. In this sense, the preparatory courses are an invaluable resource. It is also essential that each new mother can count on a solid support network, made up of partners and family members, but also of the health personnel involved in the birth process, such as gynecologists, midwives, breastfeeding consultants and paediatricians. All these figures that orbit around the new mother have the task not only of helping her in managing her own physical needs and those of the child, but also of welcoming her, listening to her and understanding her. In order to be able to experience motherhood and the physical and emotional changes associated with it with more awareness, it can be very useful to contact a perinatal mental health professional. Perinatal psychology deals with promoting and protecting the well-being of mother and child throughout the birth process. The Unobravo online psychology service can count on a team of psychologists and psychotherapists specialized in perinatal and family matters. In addition to accompanying the mother from pregnancy to the first months of the child’s life, the therapist can play a crucial role in cases of obstetric violence. Knowing that you are not alone and that you can count on the support of an expert can help the new mother process the experience and any traumas and thus be able to embrace and live fully, with joy and awareness, that wonderful journey that is motherhood ».
Opening photo of the UnoBravo press office