Practices and Components Associated With Woman-Centered Obstetric Care in a Population in Mexico: A Cross-Sectional Study

TL;DR

This study in Mexico found that most women received good obstetric care, but some practices still violate their rights, especially regarding consent and privacy.

Contribution

The study identifies specific factors associated with woman-centered obstetric care in a Mexican population.

Findings

87.5% of women received adequate obstetric care, while 12.5% did not.

Factors like close monitoring and explanation of procedures were linked to better care.

Practices violating respectful care standards persist, especially around informed consent.

Abstract

Introduction: Obstetric violence (OV) constitutes a form of violation of women's human rights and affects the quality of maternal health care. The objective of this study is to identify manifestations of obstetric violence in the Health Services Network of the Nacajuca Health Jurisdiction, Tabasco, Mexico, and to determine the factors associated with adequate obstetric care.

Methodology: A descriptive-observational, cross-sectional study was conducted on 268 participants, including 216 postpartum women and 52 health professionals. The Woman-Centered Obstetric Care Index (WCOCI) was applied in accordance with the provisions set forth in NOM-007-SSA2-2016. Frequencies, chi-squared tests, and Pearson's correlation were calculated. Prevalence ratios (PRs) were estimated using Poisson models with robust variance, with 95% confidence intervals (CIs).

Results: Of the patients, 87.5% received adequate care, while 12.5% received inadequate care. The factors associated with adequate care were as follows: close monitoring (PR=1.72, 95% CI: 1.30-2.28), explanation of procedures (PR=1.55, 95% CI: 1.20-2.00), prior authorization for vaginal examination (PR=1.40, 95% CI: 1.05-1.87), accompaniment by a family member (PR=1.32, 95% CI: 1.01-1.70), and respect for the time needed (PR=1.28, 95% CI: 1.00-1.65).

Conclusions: While the majority of women received adequate obstetric care, there is a persistent prevalence of practices that contravene established standards of respectful care, particularly concerning informed consent and privacy. The implementation of continuous training strategies and woman-centered care protocols is imperative.