Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 14;16(12):e0261204.
doi: 10.1371/journal.pone.0261204. eCollection 2021.

Health workers' disrespectful and abusive behaviour towards women during labour and delivery: A qualitative study in Durban, South Africa

Sphindile Mapumulo  1 , Lyn Haskins  1 , Silondile Luthuli  1 , Christiane Horwood  1
Affiliations

Health workers' disrespectful and abusive behaviour towards women during labour and delivery: A qualitative study in Durban, South Africa

Sphindile Mapumulo et al. PLoS One. .

Abstract

Background: A high prevalence of disrespectful and abusive behaviour by health workers towards women during labour and delivery has been widely described in health facilities, particularly in Africa, and is a worldwide public health concern. Such behaviours are barriers to care-seeking, and are associated with adverse outcomes for mothers and newborns. This paper reports experiences of disrespectful care among informal working women in three public health facilities in Durban, South Africa.

Methods: A qualitative longitudinal study was conducted among a cohort of informal working women recruited during pregnancy in two clinics in Durban. The study comprised a series of in-depth interviews conducted at different time points from pregnancy until mothers had returned to work, followed by focus group discussions (FGDs) with cohort participants. We present data from participatory FGDs, known as 'Journey with my Baby', conducted at the end of the study, during which women's experiences from pregnancy until returning to work were reviewed and explored. Thematic analysis was used with NVIVO v12.4.

Results: Three 'Journey with my Baby' FGDs were conducted with a total of 15 participants between March and October 2019. Many participants narrated experiences of disrespectful behavior from nurses during labour and childbirth, with several women becoming very distressed as a result. Women described experiencing rudeness and verbal abuse from nurses, lack of privacy and confidentiality, nurses refusing to provide care, being denied companionship and being left unattended for long periods during labour. Women described feeling anxious and unsafe while in the labour ward because of the behaviour they experienced directly and observed other patients experiencing. Such experiences created bad reputations for health facilities, so that women in the local community were reluctant to attend some facilities.

Conclusion: Disrespect and abuse continues to be a serious concern in public health facilities in South Africa. We challenge the health system to effectively address the underlying causes of disrespectful behavior among health workers, initiate robust monitoring to identify abusive behavior when it occurs, and take appropriate actions to ensure accountability so that women receive the high-quality maternity care they deserve.

PubMed Disclaimer

Conflict of interest statement

The authors have declared no competing interest.

Figures

Fig 1
Fig 1. One woman’s story.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. United Nations. The Sustainable Development Goals Report 2019. New York. 2019.
    1. Kinney MV, Kerber KJ, Black RE, Cohen B, Nkrumah F, Coovadia H, et al.. Sub-Saharan Africa’s mothers, newborns, and children: where and why do they die? PLoS medicine. 2010;7(6):e1000294. doi: 10.1371/journal.pmed.1000294 - DOI - PMC - PubMed
    1. Rosen HE, Lynam PF, Carr C, Reis V, Ricca J, Bazant ES, et al.. Direct observation of respectful maternity care in five countries: a cross-sectional study of health facilities in East and Southern Africa. BMC pregnancy and childbirth. 2015;15(1):306. doi: 10.1186/s12884-015-0728-4 - DOI - PMC - PubMed
    1. Das JK, Kumar R, Salam RA, Lassi ZS, Bhutta ZA. Evidence from facility level inputs to improve quality of care for maternal and newborn health: interventions and findings. Reproductive health. 2014;11(S2):S4. doi: 10.1186/1742-4755-11-S2-S4 - DOI - PMC - PubMed
    1. World Health Organization. Quality, equity, dignity: the network to improve quality of care for maternal, newborn and child health: strategic objectives. 2018.

Publication types

MeSH terms