Disrespect and abuse during facility-based childbirth and its sociodemographic determinants - A barrier to healthcare utilization in rural population
- PMID: 30911513
- PMCID: PMC6396581
- DOI: 10.4103/jfmpc.jfmpc_247_18
Disrespect and abuse during facility-based childbirth and its sociodemographic determinants - A barrier to healthcare utilization in rural population
Abstract
Context: The provider-driven disrespect and abuse (DA) of women during childbirth is a marker for quality of maternal care and violation of basic human rights.
Aims: This study was done to assess prevalence and sociodemographic determinants of DA experienced during facility-based childbirth.
Settings and design: This is a cross-sectional, community-based study done in six villages in the district of Aligarh, north India.
Subjects and methods: In all, 305 women who underwent facility-based childbirth were interviewed by pretested and structured questionnaire at home between 4 and 6 weeks postpartum period.
Statistical analysis used: Descriptive statistics, Chi-square test, and bivariate regression analysis using SPSS 20.0 were used.
Results: A total of 257 (84.3%) of 305 women reported any form of DA. Nonconsented services (71.1%) and nonconfidential care (62.3%) were the most common types. Abandonment/neglect during childbirth was reported by 10.2% women, nondignified care by 9.2%, physical abuse by 5.9%, detention in the health facility by 3.3%, and discrimination by 3.9%. Women who had undergone vaginal birth [odds ratio (OR) 3.36; confidence interval (CI) 1.7-6.5], at public health facility (OR 2.65; CI 1.4-5.0), given care by providers other than doctors (OR 2.89; CI 1.5-5.5), who belonged to low socioeconomic status (OR 3.68; CI 1.4-9.7), and who did not decide place of delivery themselves (OR 4.49; CI 2.0-12.1) were more at risk of DA. Out of all females unwilling to attend facility in future, 93.8% reported experiencing DA. The association between any DA and decision to attend the facility in future was statistically significant.
Conclusion: More than 8 of 10 women experienced any DA during facility-based childbirth. It can be a barrier to utilization of facility for childbirth. Preventing DA is important to improve quality of maternal care and institutional deliveries.
Keywords: Abuse; childbirth; disrespect; facility; maternal care.
Conflict of interest statement
There are no conflicts of interest.
Figures
References
-
- 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. [Last cited on 2018 Jun 20];Bull World Health Organ [Internet] 2014 92:915–7. Available from: http://www.ncbi. nlm.nih.gov/pubmed/25552776 . - PMC - PubMed
-
- Bowser D, Hill K. Exploring evidence for disrespect and abuse in facility-based childbirth report of a landscape analysis. Harvard Sch Public Heal Univ Res Co, LLC [Internet] 2010. pp. 1–57. Available from: http://www.urc-chs.com/uploads/resourceFiles/Live/RespectfulCareatBirth9... .
-
- Sen G, Reddy B, Iyer A. Beyond measurement: The drivers of disrespect and abuse in obstetric care? Reproductive Health Matters. 2018:1–13. DOI:10.1080/09688080.2018.1508173. - PubMed
-
- Balde MD, Diallo BA, Bangoura A, Sall O, Soumah AM, Vogel JP, et al. Perceptions and experiences of the mistreatment of women during childbirth in health facilities in Guinea: A qualitative study with women and service providers. Reprod Health [Internet] 2017. pp. 1–13. Available from: http://dx.doi.org/10.1186/s12978-016-0266-1 . - PMC - PubMed