The experience of pregnancy and childbirth overshadowed by obstetric violence and structural barriers of the Israeli health system from the perspective of Arab and Jewish women
BY RAGHDA ALNABILSY & DGANIT SHARON
Women’s periods of reproduction and childbirth are characterized by major changes in their bodies and lives. For many women, childbirth is a key event in their lives, and they develop strong expectations towards this experience. Unfortunately, in the last two decades there is increased evidence about abusive behaviors towards women by no other than health professionals. These behaviors were named ‘obstetric violence. A look at the literature reveals various definitions for obstetric violence such as ‘dehumanized care’, ‘disrespect’, ‘abuse’, and ‘mistreatment of women’. These experiences could be manifested by intentional physical violence, passive unintentional violence (such as neglect due to staff shortages or overload), violence by individuals including verbal violence, or health system conditions, which is due to insufficient conditions could damage privacy and confidentiality. However it is worth noticing that research has shown obstetric violence is rooted in gender and social perceptions that affect all those involved.
In our study, the aim was to give a voice to Arab (who belong to an ethnic minority in Israel) and Jewish women in Israel who had suffered obstetric violence during various stages of fertility treatments, pregnancy, and childbirth. In addition, to learn from the women about their experiences of obstetric violence subject to the barriers of the Israeli health system, and their recommendations of possible solutions. The study underlines the unique gender, social and cultural context in Israel concerning pregnancy and childbirth and was based on the feminist approach that strives to promote human rights, and eradicate phenomena of gender-related, patriarchal and social structures. It is worth mentioning that our study perspective is that medical personnel do not deliberately harm women but perpetuate a patriarchal culture.
The study used a qualitative-constructivist methodology. Twenty semi-structured interviews with ten Arab women and ten Jewish women were thematically analyzed, and five main themes emerged. First, the women’s experience of becoming pregnant and pregnancy overshadowed by physical and emotional barriers from caregivers and the close environment. Second, the women’s awareness of their bodies and needs during pregnancy dominated by the challenges of the health services. Third, the women’s awareness of their bodies and needs during childbirth alongside incompatible expectations and nonattentive medical staff. Fourth, the women’s descriptions of experiences and types of obstetric violence. Fifth, the women’s recommendations to eradicate obstetric violence.
One more interesting result was that Arab women (who belong to an ethnic minority in Israel) reported experiences that were very similar to those of Israeli-Jewish women. This finding strengthens the claim that obstetric violence is based on gender violence directed specifically at women.
This qualitative study has expanded the knowledge concerning obstetric violence as a process that takes place on a continuum from fertility treatments to childbirth experiences among Jewish and Arab women, and has examined this issue within gender contexts alongside structural barriers of the healthcare system in Israel. Also, this study not only gives a voice to women’s experiences, but also brings their insights and suggestions to eradicate the problem, in belief that they have the knowledge, and – together with them – we can formulate solution and answers.
Article Details
The Experience of Pregnancy and Childbirth Overshadowed by Obstetric Violence and Structural Barriers of the Israeli Health System from the Perspective of Arab and Jewish Women
Alnabilsy, R., & Sharon, D.
First Published May 3, 2023 Research Article
DOI: 10.1177/10497323231173814
Qualitative Health Research
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