1. ABSTRACT 1.1 INTRODUCTION Obstetric violence is a part of a larger and equally complex frame of gender violence. In Italy, only recently has awareness of this phenomenon grown, awareness raised also thanks to campaigns such as #bastatacere, that started in 2016 and was followed by the creation of the “Osservatorio sulla violenza ostetrica (OVO)” (Observatory for obstetric violence), which is a reference point for women on this phenomenon. There are many regulatory frameworks on this issue. The specific regulations adopted by different states vary, but in recent years the WHO has expressed itself on the matter, however, fortunately it has not been the only organization to do so; in fact, even the Human Rights Council of the United Nations and the European Council have expressed their views on this topic. Finally, closer to home, in Italy a law has been proposed, which also provides sanctions of a criminal nature, but has been under consideration in the Parliament since 2016. Obstetric violence is a phenomenon that is manifested in various ways, with more or less obvious signs. Starting with more psychological violence, which can be much more subtle than other forms of violence and therefore even more difficult to identify than other forms of violence such as physical violence. Due to this complexity of the phenomenon, it is difficult to define as often obstetric violence can be more so a lack of action rather than an action itself. For example, it can be manifested in the form of negligence or incompetence of the caregivers and therefore of the treatments provided. It is essential to educate woman to recognize it, so that they may identify it and defend their individual integrity. 1.2 MATERIALS AND METHODS To investigate the phenomenon, especially the aspect of awareness on the subject, I created, and then administered an ad hoc survey. The participants were all women who had, for various reasons, contact with the hospital service or more generally with healthcare workers for obstetric-gynaecological needs. The data collection took place on an online platform called “Survio” and the collected data were processed and then analyzed with Microsoft Excel (version 2018) and R (version 4.0.3(2020-10-10)) software. 1.3 RESULTS AND DISCUSSION The results of this study confirm what already exists in the literature, namely that obstetric violence is a phenomenon that women claim to understand, and therefore can identify; however, not all women find these events necessarily harmful, and this also reflects the studies done in the literature, as well as the imprint that these events leave on the psyche of patients. Another interesting fact is that often the request for consent is not counted among the practices that are part of obstetric violence. Finally, the most common practices were shown to be the episiotomy and the Kristeller maneuver.
1. RIASSUNTO 1.1 INTRODUZIONE La violenza ostetrica rientra in un quadro più grande e altresì complesso della violenza genere. In Italia, solo di recente, si sta sviluppando più consapevolezza su questo fenomeno, consapevolezza che si sta acquisendo anche grazie a compagne di sensibilizzazione come quella di #bastatacere che è nata e si è diffusa a partire dal 2016 e a cui ha fatto seguito la creazione dell’Osservatorio sulla violenza ostetrica, punto di riferimento delle donne per questo fenomeno. I quadri normativi su questa problematica sono molteplici. Le normative specifiche adottate dai vari Stati sono varie, ma negli ultimi anni anche l’Organizzazione mondiale della sanità si è espressa in merito, tuttavia, fortunatamente, non è stata l’unica organizzazione a farlo; infatti, anche il Consiglio per i diritti umani delle Nazione Unite e il Consiglio d’Europa si sono espressi su questa tematica. Infine, più vicino al nostro contesto, in Italia è stata fatta una proposta di legge, che prevede anche delle sanzioni di carattere penale, ma è dal 2016 in esame al Parlamento. La violenza ostetrica è un fenomeno che si articola in vari modi, con manifestazioni più o meno evidenti. Passiamo infatti dalla violenza psicologica, che decisamente può essere più subdola rispetto ad altre forme di violenza e dunque può essere anche più difficile da identificare, ad altre forme di violenza quali la violenza fisica, decisamente molto più individuabile. Proprio per questo aspetto prismatico del fenomeno è difficile definirlo perché spesso la violenza ostetrica può anche essere un non fare qualcosa piuttosto che farla, ad esempio essa può esprimersi sotto forma di negligenza o di incompetenza degli operatori e dunque dei trattamenti erogati. È essenziale educare le donne a riconoscerla, così da poterla individuare e difendere la loro integrità individuale 1.2 MATERIALI E METODI Per indagare il fenomeno, in particolar modo l’aspetto della consapevolezza sul tema, ho creato e poi somministrato un questionario ad hoc. Le partecipanti sono donne che hanno avuto contatto, per vari motivi, con il contesto ospedaliero o più in generale con gli operatori sanitari, per esigenze ostetrico-ginecologiche. La raccolta dei dati è avvenuta su una piattaforma online chiamata “Survio” e i dati raccolti sono stati sintetizzati e poi analizzati con il software Microsoft Excel (versione 2018) e R (versione 4.0.3(2020-10-10)). 1.3 RISULTATI & DISCUSSIONE I risultati di questa tesi hanno confermato ciò che già esiste in letteratura, vale a dire che la violenza ostetrica è un fenomeno che le donne dichiarano di conoscere, e quindi di saper identificare; tuttavia, non tutte le donne trovano questi avvenimenti necessariamente lesivi, e anche questo rispecchia gli studi fatti in letteratura, così come l’impronta che lasciano questi avvenimenti sulla psiche delle pazienti. Un altro dato interessante è che spesso la richiesta di consenso non è annoverata tra le pratiche facenti parte della violenza ostetrica. Infine, le pratiche più diffuse si sono dimostrate essere l’episiotomia e la manovra di Kristeller.
LA VIOLENZA OSTETRICA: UNA QUESTIONE ANCHE DI CONSAPEVOLEZZA
DOUMI, OUMAIMA
2020/2021
Abstract
1. ABSTRACT 1.1 INTRODUCTION Obstetric violence is a part of a larger and equally complex frame of gender violence. In Italy, only recently has awareness of this phenomenon grown, awareness raised also thanks to campaigns such as #bastatacere, that started in 2016 and was followed by the creation of the “Osservatorio sulla violenza ostetrica (OVO)” (Observatory for obstetric violence), which is a reference point for women on this phenomenon. There are many regulatory frameworks on this issue. The specific regulations adopted by different states vary, but in recent years the WHO has expressed itself on the matter, however, fortunately it has not been the only organization to do so; in fact, even the Human Rights Council of the United Nations and the European Council have expressed their views on this topic. Finally, closer to home, in Italy a law has been proposed, which also provides sanctions of a criminal nature, but has been under consideration in the Parliament since 2016. Obstetric violence is a phenomenon that is manifested in various ways, with more or less obvious signs. Starting with more psychological violence, which can be much more subtle than other forms of violence and therefore even more difficult to identify than other forms of violence such as physical violence. Due to this complexity of the phenomenon, it is difficult to define as often obstetric violence can be more so a lack of action rather than an action itself. For example, it can be manifested in the form of negligence or incompetence of the caregivers and therefore of the treatments provided. It is essential to educate woman to recognize it, so that they may identify it and defend their individual integrity. 1.2 MATERIALS AND METHODS To investigate the phenomenon, especially the aspect of awareness on the subject, I created, and then administered an ad hoc survey. The participants were all women who had, for various reasons, contact with the hospital service or more generally with healthcare workers for obstetric-gynaecological needs. The data collection took place on an online platform called “Survio” and the collected data were processed and then analyzed with Microsoft Excel (version 2018) and R (version 4.0.3(2020-10-10)) software. 1.3 RESULTS AND DISCUSSION The results of this study confirm what already exists in the literature, namely that obstetric violence is a phenomenon that women claim to understand, and therefore can identify; however, not all women find these events necessarily harmful, and this also reflects the studies done in the literature, as well as the imprint that these events leave on the psyche of patients. Another interesting fact is that often the request for consent is not counted among the practices that are part of obstetric violence. Finally, the most common practices were shown to be the episiotomy and the Kristeller maneuver.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/8522