UC San Diego

Background: Structural violence is a persistent but silent form of violence in Mexico. This dissertation evaluated two predominant health issues among women in Mexico that are a result of structural violence: access to nutrition for low-income women during pregnancy and different forms of gender-based violence (GBV), including obstetric violence.Objectives: To assess the nutritional knowledge, education, and practices employed among Oaxacan women during their pregnancy, as well as their prenatal supplemental acquisition and use behaviors (Chapter 2); explore the themes covered by Mexican non-governmental organizations (NGOs) on X (formerly Twitter) during the 2020-2022 ‘16 Days of Activism Against GBV’ annual campaigns, and to examine what types of messages related to GBV potentially resonated more with the public (Chapter 3); and measure the prevalence and assess change over time of non-consented care during childbirth in Mexico in 2016 and 2021, as well as examine the association of sociodemographic, pregnancy-, and childbirth-factors with this type of violence (Chapter 4). Methods: This dissertation includes three studies. A qualitative study was carried out in Puerto Escondido and Oaxaca City in the state of Oaxaca through 25 semi-structured interviews (Chapter 2); a thematic content analysis of the most liked tweets published by Mexican-based NGOs for the 2020-2022 ‘16 Days of Activism Against GBV’ campaigns (Chapter 3); and data from Mexico’s cross-sectional National Survey on the Dynamics of Household Relationships (ENDIREH) for 2016 and 2021 was utilized for Chapter 4. Results: Different social positions and relationships at the meso- and macro-levels guided the nutritional knowledge and practices during pregnancy, as life experiences, sociodemographic and health characteristics, family members, and health provided mainly influenced knowledge and practices (Chapter 2). For the thematic content analysis, themes covering both knowledge-sharing and activism-generating messages emerged (Chapter 3). The national prevalence of non-consented care and one of its variations, pressure to get a contraceptive method, increased from 2016 to 2021, while the rest of the variations decreased nationally and in most regions. (Chapter 4) Conclusions: Findings from this dissertation advance the study of GBV, non-consented care during childbirth, and nutrition knowledge and practices during pregnancy in Mexico. Recommendations for future research are discussed.