Data from a survey on obstetric violence in Italy has been published: too many caesarean sections, unauthorised episiotomies, verbal violence and loneliness.
Over one million Italian mothers with children under 14 (equal to 21 per cent of the total) believe they were victims of obstetric violence during their first birth. This is the main finding to emerge from the national survey "Le donne e il parto" ("Women and childbirth"), commissioned from Doxa by the Osservatorio sulla violenza ostetrica Italia and funded by the associations La goccia magica and CiaoLapo onlus.
Those surveyed were asked to respond to the following question: "The definition of obstetric violence is as follows: appropriation of a woman's reproductive processes by medical staff, forcing a woman to undergo an unnecessary caesarean section, forcing a woman to undergo an unnecessary episiotomy, forcing a woman to give birth lying down with her legs in stirrups, exposing a woman naked in front of multiple individuals, separating mother and child without a medical reason, not involving the woman in the decision-making processes concerning her own body and her own birth, verbally humiliating the woman before, during and after childbirth. Based on this information, do you believe you experienced obstetric violence during the care provided at your birth?"
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Over one fifth of Italian women who gave birth in the last 14 years, then, feel they suffered some form of psychological or physical violence from the practitioners who assisted at the birth. The survey, conducted on a representative sample of around 5 million Italian women aged between 18 and 54, reveals that 41 per cent of those interviewed underwent "practices that harmed their dignity or psychophysical integrity." Chief among these is episiotomy, which the World Health Organization defines as "a harmful practice, except in rare cases," yet which in Italy is still performed on 54 per cent of women in labour. More than half of the women who underwent it (61 per cent) had not given their informed consent, and 15 per cent experienced it not only as a form of obstetric violence, but as a genuine mutilation of the genital organs. The highest number of episiotomies is recorded at birthing units in southern Italy and the islands, at 58 per cent.
The caesarean section rate also remains high, performed in 32 per cent of cases against a European average of below 25 per cent. In 15 per cent of cases these were emergency procedures, while in a further 14 per cent, the caesarean was planned on the basis of medical indications. Beyond the interventions undergone during childbirth, one third of Italian women who became mothers in the last 14 years report not having received the care they would have wished for: 27 per cent cite a lack of information on how to begin breastfeeding, while 19 per cent suffered a lack of privacy during their hospital stay. Other forms of obstetric violence reported by those interviewed include being prohibited from having a trusted person nearby during labour (12 per cent) and the absence of adequate pain management (13 per cent). Six per cent, meanwhile, say they experienced the entire birth alone and without the necessary assistance.
Around 4 per cent of Italian mothers (that is, 14,000 women per year) also identified negligence on the part of hospital staff in the management of complications arising around the time of birth — negligence that ultimately exposed the new mother or the newborn to risk to their life. For 6 per cent of those surveyed, the experience of childbirth was so traumatic that it led them to give up on the possibility of having more children. The survey "Le donne e il parto" was carried out after the Osservatorio sulla violenza ostetrica in Italia had launched, in April 2016, the #BastaTacere social campaign, which quickly went viral, in which women were invited to share the negative experiences they had endured during labour and childbirth. "In the face of this objective picture of the phenomenon," declared Alessandra Battisti, co-founder of the Osservatorio, "we hope for collaboration with doctors and institutions aimed at including women in the decision-making processes — political ones too — that bring about a real change in care in the direction of respect for and the dignity of the human person."
