Obstetric Violence and its Impact on the Mental Well-being of Ecuadorian women: A Quantitative Approach

Obstetric violence refers to certain practices and behaviors carried out by health professionals towards women that belittle, violate and oppress them during pregnancy, childbirth and puerperium, whether in public or private settings. This type of violence is interpreted as a form of gender discrimination and represents a violation of human rights that has a direct impact on women's mental well-being. It manifests itself mainly as an inequality of power between healthcare professionals and pregnant women, whether during childbirth or the puerperium. The World Health Organization has stressed the importance of eliminating these harmful medical practices, urging medical personnel to react appropriately through dialogue and support for pregnant women. A nationally representative sample of women aged 12 years and older from the 2018 National Health and Nutrition Survey was used. Multicollinearity tests were used to avoid redundant information in the models. Next, we used factor analysis to generate an index of obstetric violence and performed linear regressions to observe the correlation between obstetric violence and mental well-being of women in our sample. Finally, we addressed the heterogeneity observed in the proposed relationship by using quantile regression techniques to disentangle the heterogeneous relationship in the distribution of mental well-being and obtain correlation coefficients, with their 95% confidence intervals (95% CI). Based on our findings, we highlight the urgent need to raise awareness and sensitize health professionals about this specific problem, since our main result indicates that there is a misleading correlation between obstetric violence and women's mental well-being. It is crucial to modify those health practices that violate women's rights. Another significant measure to improve the current situation would be the implementation of programs that give visibility to gender violence in the health sector, as well as the promotion of research focused on obstetric violence and the implementation of interventions that strengthen the autonomy of users.