An indicator of gender equality is much more better in Europe compared to else in t he world it could be due to the presence of midwives in their society since midwives empower women in their capability of giving birth that nature has gifted.
It is a hight time for Nepal and Nepalese working to improve gender equality in order to achieve sustainable development goals 3.1 (by 2030 reduce the global maternal mortality ratio to less than 70 per 100,000 live births specific maternal health indicator) and 5 (Gender Equality) including overall since without gender equality no society can inspire to work both men and women in achieving sustainable development goals of its nation.
In Nepal there is an evidence that many more pregnant women are suffering from "Obstetric Violence" a new legal term introduced in Venezuela of which an editorial article has been by Dr. Rogelio Pérez D’Gregorio, President of the Society of Obstetrics and Gynaecology of Venezuela in the International Journal of Gynaecology and Obstetrics written in October 6, 2010.
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 caesarean section, when natural childbirth is possible, without obtaining voluntary, expressed, and informed consent from the woman.
In Nepal both in private and public health facilities pregnant women are massively suffering from Obstetric Violence but types of Obstetric Violence varies between public and private. In the private and semi-government sectors high rate of C-section that varies from 40-99% we find and in public sector especially related to health professionals attitude and behaviour we observe and pregnant women and their family members experience. These has to addresses by the concerned professionals and authorities as earliest as possible. Otherwise only designing policies and providing chocolate speeches won't help to address the problems that our pregnant women are facing while giving new life on this planet to sustain humanity.