Obstetrik şiddet kadınların, bedenleri ve reprodüktif süreçleriyle ilgili otonomilerinin insanlık dışı olarak tabir edilen muamelelerle ellerinden alınması, tıbbileştirmenin kötüye kullanımı ve doğal süreçlerin patolojik hâle gelmesidir. Reprodüktif süreçlerin herhangi bir aşamasında karşılaşılabilen, kadınların kaliteli sağlık hizmeti almasını engelleyen hem anne hem de bebek sağlığı açısından olumsuz sonuçlar doğurabilen bir fenomendir. Şiddet algısının toplumsal, kültürel ve bireysel bağlamlardan etkilenmesi kavramın tanımını zorlaştırmaktadır. Kavramın tanımlanması adına yapılan çalışmalarda ''kötü muamele''ye odaklanılsa da kapsamlı bir ortak tanım ve terimlendirme mevcut değildir. Mevcut araştırmalarda kullanılan pek çok kötü muamele tanımı; ''saygısızlık ve istismar'', ''doğum sırasında kötü muamele'' ve ''obstetrik şiddet'' olarak ifade edilen üç kavramın birleşimidir. Adlandırma bağlamında literatürde birçok fikir ayrılığı mevcuttur. Adlandırmaya yönelik kavramsal bir temel, yaygınlığının daha iyi bilinmesine, daha fazla çalışma yapılarak doğabilecek olumsuz sonuçlar konusunda farkındalık yaratılmasına ve önlem alınmasına olanak sağlayacaktır. Ayrıca kavramın çok boyutluluğunu vurgulayan bir adlandırma fenomenin önlenmesi konusunda farklı disiplinlerin de katkılarıyla kanıt temelli ulusal sağlık politikalarının oluşturulması için zemin hazırlanmasına katkıda bulunacaktır. Ülkemizde yeni yeni tartışılmaya başlanan bu fenomen dünyada çok çeşitli bağlamlarda uzun yıllardır çalışılmaktadır. Bu derlemede amaç, literatür doğrultusunda adlandırma bağlamındaki sorunları, adlandırma çalışmalarını, şiddet kelimesi yerine kullanılan terimler ve neden kullanıldığı ile bu konudaki fikir ayrılıklarını ve bunların nedenlerini ortaya koymaktır.
Anahtar Kelimeler: Şiddet; obstetrik şiddet; adlandırma; doğum
Obstetric violence is the deprivation of women's autonomy regarding their bodies and reproductive processes through inhumane treatments, abuse of medicalization, and pathology of natural processes. It is a phenomenon that can be encountered at any stage of reproductive processes which can have negative consequences for both maternal and infant health, preventing women from receiving quality health care. The fact that the perception of violence is affected by social, cultural and individual contexts makes the definition of the concept difficult. Although the studies on the definition of the concept focus on ''mistreatment'', there is no comprehensive common definition and terminology on the subject. Many definitions of mistreatment used in existing research are a combination of three concepts: "disrespect and abuse", "mistreatment during labour" and "obstetric violence". There are many differences of opinion in the literature in the context of naming. A conceptual basis for naming will allow its prevalence to be better known, awareness about the negative consequences that may arise by conducting more studies, and precautions to be taken. In addition, a naming that emphasizes the multidimensionality of the concept will contribute to preparing the ground for the creation of evidence-based national health policies with the contributions of different disciplines on the prevention of the phenomenon. This phenomenon, which has just begun to be discussed in our country, has been studied for many years in various contexts in the world. The aim of this review, in line with the literature, is to reveal the problems in the context of naming, naming studies, the terms used instead of the word violence and why they are used, the disagreements on this issue and their reasons.
Keywords: Violence; obstetric violence; naming; childbirth
- Butchart A, Phinney A, Check P, Villaveces A. Preventing violence: a guide to implementing the recommendations of the World report on violence and health. Department of Injuries and Violence Prevention, World Health Organization: Geneva; 2004. Cited: October 25, 2022. Available from: [Link]
- American Psychological Association [Internet] © 2022 American Psychological Association [Cited: October 22, 2022]. APA Dictionary of Psychology Violence. Available from: [Link]
- Resmî Gazete (20.03.2012/28239), 6284 sayılı Ailenin Korunması ve Kadına Karşı Şiddetin Önlenmesine Dair Kanun; 2012. [Erişim tarihi: 22 Ekim 2022]. Erişim linki: [Link]
- Güleç H, Topaloğlu M, Ünsal D, Altıntaş M. Bir kısır döngü olarak şiddet [Violence as a vicious cycle]. Psikiyatride Güncel Yaklaşımlar. 2012;4(1):112-37. [Link]
- World Health Organization. The prevention and elimination of disrespect and abuse during facility-based childbirth. 2015. Cited: October 22, 2022. Available from: [Link]
- Ferrão AC, Sim-Sim M, Almeida VS, Zangão MO. Analysis of the concept of obstetric violence: scoping review protocol. J Pers Med. 2022;12(7):1090. [Crossref] [PubMed] [PMC]
- Savage V, Castro A. Measuring mistreatment of women during childbirth: a review of terminology and methodological approaches. Reprod Health. 2017;14(1):138. [Crossref] [PubMed] [PMC]
- Cohen Shabot S. Making loud bodies "feminine": a feminist-phenomenological analysis of obstetric violence. Hum Stud. 2016;39(2):231-47. [Crossref]
- Leite TH, Marques ES, Esteves-Pereira AP, Nucci MF, Portella Y, Leal MDC. Disrespect and abuse, mistreatment and obstetric violence: a challenge for epidemiology and public health in Brazil. Cien Saude Colet. 2022;27(2):483-91. Portuguese, English. [Crossref] [PubMed]
- Katz L, Amorim MM, Giordano JC, Bastos MH, Brilhante AVM. Who is afraid of obstetric violence? Revista Brasileira de Saúde Materno Infantil. 2020;20:623-6. [Crossref]
- Williams CR, Jerez C, Klein K, Correa M, Belizán JM, Cormick G. Obstetric violence: a Latin American legal response to mistreatment during childbirth. BJOG. 2018;125(10):1208-11. [Crossref] [PubMed]
- Brice-o Morales X, Enciso Chaves LV, Yepes Delgado CE. Neither medicine nor health care staff members are violent by nature: obstetric violence from an interactionist perspective. qual Health Res. 2018;28(8):1308-19. [Crossref] [PubMed]
- Pérez D'Gregorio R. Obstetric violence: a new legal term introduced in Venezuela. Int J Gynaecol Obstet. 2010;111(3):201-2. [Crossref] [PubMed]
- Bowser D, Hill K. Exploring evidence for disrespect and abuse in facility-based childbirth. Boston: USAID-TRAction Project, Harvard School of Public Health University Research Co., LLC; 2010. Cited: October 22, 2020. Available from: [Link]
- Freedman LP, Ramsey K, Abuya T, Bellows B, Ndwiga C, Warren CE, et al. Defining disrespect and abuse of women in childbirth: a research, policy and rights agenda. Bull World Health Organ. 2014;92(12):915-7. [Crossref] [PubMed] [PMC]
- Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. PLoS Med. 2015;12(6):e1001847; discussion e1001847. [Crossref] [PubMed] [PMC]
- Jewkes R, Penn-Kekana L. Mistreatment of Women in Childbirth: Time for Action on This Important Dimension of Violence against Women. PLoS Med. 2015;12(6):e1001849. [Crossref] [PubMed] [PMC]
- Bohren MA, Adu-Bonsaffoh K, Irinyenikan TA, Maung TM, Balde MD, Tunçalp Ö. Mistreatment during childbirth - Authors' reply. Lancet. 2020;396(10254):817-8. [Crossref] [PubMed]
- Ravaldi C, Skoko E, Battisti A, Cericco M, Vannacci A. Abuse and disrespect in childbirth assistance in Italy: a community-based survey. Eur J Obstet Gynecol Reprod Biol. 2018;224:208-9. [Crossref] [PubMed]
- Scambia G, Viora E, Chiantera A, Colacurci N, Vicario M. "Obstetric violence": Between misunderstanding and mystification. Eur J Obstet Gynecol Reprod Biol. 2018;228:331. [Crossref] [PubMed]
- Rost M, Arnold L, De Clercq E. "Boiling up the problem of violence" in childbirth?-an ethical viewpoint on medical professional responses to women's reports of mistreatment in childbirth. Ethik Med. 2020;32:89-193. [Crossref]
- Lappeman M, Swartz L. How gentle must violence against women be in order to not be violent? Rethinking the word "violence" in obstetric settings. Violence Against Women. 2021;27(8):987-1000. [Crossref] [PubMed]
- Lévesque S, Ferron-Parayre A. To use or not to use the term "obstetric violence": commentary on the article by swartz and lappeman. Violence Against Women. 2021;27(8):1009-18. [Crossref] [PubMed] [PMC]
- Salter CL, Olaniyan A, Mendez DD, Chang JC. Naming silence and inadequate obstetric care as obstetric violence is a necessary step for change. Violence Against Women. 2021;27(8):1019-27. [Crossref] [PubMed]
- van der Waal R, Mayra K, Horn A, Chadwick R. Obstetric violence: an intersectional refraction through abolition feminism. Feminist Anthropology. 2022;4(1):91-114. [Crossref]
- Kujawski S, Mbaruku G, Freedman LP, Ramsey K, Moyo W, Kruk ME. Association between disrespect and abuse during childbirth and women's confidence in health facilities in Tanzania. Matern Child Health J. 2015;19(10):2243-50. [Crossref] [PubMed]
- Patel P, Makadia K, Kedia G. Study to assess the extent of disrespect and abuse in facility based child birth among women residing in urban slum area of Ahmedabad. Int J Multidiscip Res Dev. 2015;2(8):25-7. [Link]
- Peca E, Sandberg J. Modeling the relationship between women's perceptions and future intention to use institutional maternity care in the Western Highlands of Guatemala. Reprod Health. 2018;15(1):9. [Crossref] [PubMed] [PMC]
- Schroll AM, Kjærgaard H, Midtgaard J. Encountering abuse in health care; lifetime experiences in postnatal women - a qualitative study. BMC Pregnancy Childbirth. 2013;13:74. [Crossref] [PubMed] [PMC]
- Lukasse M, Schroll AM, Karro H, Schei B, Steingrimsdottir T, Van Parys AS, et al; Bidens Study Group. Prevalence of experienced abuse in healthcare and associated obstetric characteristics in six European countries. Acta Obstet Gynecol Scand. 2015;94(5):508-17. [Crossref] [PubMed]
- Silveira MF, Mesenburg MA, Bertoldi AD, De Mola CL, Bassani DG, Domingues MR, et al. The association between disrespect and abuse of women during childbirth and postpartum depression: Findings from the 2015 Pelotas birth cohort study. J Affect Disord. 2019;256:441-7. [Crossref] [PubMed] [PMC]
- Amorim MM, da Silva Bastos MH, Katz L. Mistreatment during childbirth. Lancet. 2020;396(10254):816. [Crossref] [PubMed]
- Kilci Ş, Bozkurt ÖD, Saruhan A. Bir kadın hakkı ihlali: obstetrik şiddet [A violation of women's rights: obstetric violence]. Arşiv Kaynak Tarama Dergisi. 2020;29(2):122-8. [Crossref]
- Kaya Z, Hotun Şahin N. Kadınların obstetrik şiddet deneyimleri: sistematik derleme [Obstetric violence experiences of women: a systematic review]. Mersin Univ Saglık Bilim Derg. 2021;14(3):509-19. [Crossref]
.: İşlem Listesi