Monday, 26 January 2015

A Condom lady against Obstetric Violence in Nepal

Generally, people say an iron lady to bold and brave women who can voice and stand against any time of injustice or violence and exercise their full rights at its optimum level as best as I they can. However, I reject that title gifted by others and acknowledged with great realisation that I am a condom lady. 

I said that I am a condom lady because like condom fights against all kind of sexually transmitted infections including deadly virus, HIV and also prevents unwanted pregnancies and provide satisfaction to sexual partners I fight against social viruses such as violence, injustice, indoctrination, dogmatism, hatred, evil, devil, misogynist, sexism, genderism, manuism, corruption, feudalism, barbarism, inhumanity including all falsify, fantasy, funny, fable and fungi kinds of mindsets and thoughts that are making this world hell which I consider is heavenly place gifted by mother nature to live on for all human including plants, animals and else.

Being a health professional who had taken oath of the modern father of medicine, Hippocrates I follow his advice who said:

“Wherever the art of Medicine is loved, there is also a love of Humanity. The natural healing force within each of us is the greatest force in getting well. Make a habit of two things: to help; or at least to do no harm."

I am against obstetric violence because obstetric violence is done by health professionals for which women are helpless to protect self whereas in other kind of violence women can protect themselves if they are educated and empowered socio-economically whereas obstetric violence is bit challenging because it is committed by so-called expert in medical and nursing professionals due to Ignorance and thrust of POWER because of over capitalism mindset who runs after man-made MONEY rather than nature made, Humanity.

In Nepal, although we have low access of caesarean section service in general that's why we've low caesarean section rate of around 5% at the national level as per the recent Nepal Demographic and Health Survey 2011, however, we have very high caesarean section rate in urban areas ranging from 35 to 80% in semi-government hospitals like Patan Hospital, Teaching Hospital Maharajgung of around 35-45% whereas in private hospitals like B & B Hospital, Valley Maternity Hospital, OM Hospital, Norvic, and else caesarean section rate is as high as upto 70-80%. These rates are extremely hight then what the World Health Organization’s recommended 15 per cent. Risks of caesarean include increased need for blood transfusion, admission to intensive care, hysterectomy, or in extreme cases – death.

Dr Hannah Dahlen, Associate Professor of Midwifery at the University of Western Sydney, says of safety in childbirth, “While the birth of a live baby is of course a priority, [the rate of] perinatal mortality [should not be ignored]. Cultural, emotional, social, psychological and spiritual safety rarely appear in the mainstream debates ... Not only [do these factors] dominate women’s thinking, research indicates ignoring its importance is potentially deadly.”

Similarly, in government hospitals birthing mothers are treated like an animals by nurses using verbal abusive words psychologically torturing them and also intervening routine cutting of women's perineum during childbirth. Such attitude and behaviour of medical and nursing professionals are unacceptable in a civilised world where women's body is use as an object instead of considering her as a human being having rights to access quality, cost effect, natural humanised care while giving a life to this world to sustain. That's the reason WHY I am against evil doing actions of educated so-called experts and intellectual.

In an editorial published online on October 6, 2010 in the International Journal of Gynecology and Obstetrics, Dr. Rogelio Pérez D’Gregorio, President of the Society of Obstetrics and Gynecology of Venezuela described the specific mentions of the term “obstetric violence” as it appears in the Organic Law on the Right of Women to Be Free from Violence, enacted in Venezuela on March 16, 2007.

The law defines obstetric violence as “…the appropriation of the body and reproductive processes of women by health personnel, which is expressed as dehumanized treatment, an abuse of medication, and to convert the natural processes into pathological ones, bringing with it loss of autonomy and the ability to decide freely about their bodies and sexuality, negatively impacting the quality of life of women.”

Dr. Pérez D’Gregorio highlights two phrases for consideration, the first of which is “health personnel.” In Venezuela, this includes obstetricians, residents, medical students, nurses and technicians. Midwives are not included because, as Pérez D’Gregorio notes, “midwifery does not exist in obstetric practice in Venezuela, where all deliveries are attended by physicians in an institution.”

In addition, the phrase “the appropriation of the body and reproductive processes of women by health personnel” is, according to Pérez D’Gregorio, “contrary to good obstetric practice, whereby medication should only be used when it is indicated, the natural processes should be respected, and instrumental or surgical procedures should be performed only when the indication follows evidence-based medicine.”

The following acts executed by care providers are considered obstetric violence:

(1) Untimely and ineffective attention of obstetric emergencies;

(2) Forcing the woman to give birth in a supine position, with legs raised, when the necessary means to perform a vertical delivery are available;

(3) Impeding the early attachment of the child with his/her mother without a medical cause thus preventing the early attachment and blocking the possibility of holding, nursing or breast-feeding immediately after birth;

(4) Altering the natural process of low-risk delivery by using acceleration techniques, without obtaining voluntary, expressed and informed consent of the woman;

(5) Performing delivery via cesarean section, when natural childbirth is possible, without obtaining voluntary, expressed, and informed consent from the woman.

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