“The dead baby card!” Exploring Obstetric Violence Through Sensitive Arts-Based Research

Evidence on obstetric violence is reported globally and is a human rights violation. They are widely reported in low and middle income countries, such as India although little is known about the characteristics and nature of disrespect and abuse in perinatal services in high resource countries, such as Canada. In this talk, Dr. Kaveri Mayra presents findings of obstetric violence research from two arts based studies in India and Canada, respectively. The study from India involved co-creation of birth mapping adapted from body mapping, with the participants to understand the embodied experience of respect, disrespect and abuse during childbirth. The body maps accurately portray women’s respectful and disrespectful births and are useful to understand women’s experience of a sensitive issue in a patriarchal culture.

The study in Canada involved using an innovative arts-based method to examine narrative responses from survey participants in the RESPCCT Study who reported on perinatal experiences. 2741 provided narrative responses to the open-ended question, “If you could change one thing about your care during pregnancy, birth and after birth, what would that be?” . Analysis was guided by feminist relational discourse methods in both the studies. The voice-centered relational method (VCRM) of analysis was adapted to produce three kinds of poems; 1) Full IPoems; 2) Context Poems; and 3) Sparse IPoems from the Canadian data. The India study narratives were analysed using traditional VCRM. The India poems are from a single person’s narrative that center the participants’ voice, and the poems from Canada are thematic, that display the solidarity of collective voices around concerns around respectful care, as well as opportunities for redress and quality improvement. The women and other birthing people’s experiences of obstetric violence and recommendations for respectful care for a positive birthing experience through 15 poems, across the domains of disrespect and abuse in prenatal, intrapartum and postnatal periods of care in Canada. They shared specific gaps in care and community-responsive strategies including the need for culture matched care; trauma-informed care for those experiencing loss; and recognition of the ways conflict between care providers and models of care led to negative experiences. Participants demanded increased access to midwifery and doula care.

Both the India and Canada studies have poems titled The Dead baby card, which is a globally known form of verbal abuse used to coerce people into accepting interventions that they may not consent to usually but to achieve that consent without clear explanation. This indicates the global challenge that is obstetric violence, that can be better understood, and addressed using sensitive methods of learning and exploring such as arts-based research to address and bring sustainable changes towards person-centered care.