Exploring factors contributing to mistreatment of women during childbirth in West Bank,Palestine

BackgroundRespectful care during childbirth is a universal right for each woman in every health system, and mistreatment of women during childbirth is a major breach of this right.AimThis study aimed to explore the views of Palestinian women and healthcare providers regarding factors contributing to the mistreatment of women during childbirth at childbirth facilities in the West Bank, Palestine.MethodsA qualitative study was conducted in the West Bank, Palestine, from February 2019 to April 2019. In-depth interviews were conducted with six Palestinian women and five healthcare providers. Consent was obtained individually from each participant, and the interviews ranged from 40 to 50 min. Data collection was continued until thematic saturation was reached. Open-ended questions were asked during interviews. Thematic analysis was used to interpret the data collected from the interviews.ResultsFour themes were identified with regards to the women and healthcare providers’ views about factors contributing to the mistreatment of women during childbirth in the West Bank, Palestine: limitation in childbirth facilities, factors within the healthcare providers, the women themselves, and barriers within the community.DiscussionMistreatment of women during childbirth may occur due to the limitations of resources and staff in childbirth facilities. Some women also justified the mistreatment, and certain characteristics of the women were believed to be the factors for mistreatment.ConclusionAs the first known study of its kind in West Bank, the identified contributing factors especially the limitations of resources and staff are essential to provide good quality and respectful care at childbirth facilities.     

An experimental investigation into perceptions of disrespect during interpersonal conflict

Perceptions of disrespect are central to everyday life. Despite the importance of disrespect across various social arenas, prior research has failed to empirically examine the factors influencing these perceptions. This problem is magnified when considering that perceptions or disrespect may vary across individuals and social situations alike. Drawing from theories of social geometry and symbolic interaction, this study examines the individual and situational characteristics that inform perceptions of disrespect. Using factorial vignettes, and a large sample of students, respondents were asked to assess actors in various conflicts. Results from a series of hierarchical linear models show that perceptions of disrespect vary across individuals. The content of situations appears to drive perceptions of disrespect more than individual characteristics. Implications for future research on disrespect are discussed.     

Does it happen and why? Lived and shared experiences of mistreatment and respectful care during childbirth among maternal health providers in a tertiary hospital in Nigeria

IntroductionGlobally, mistreatment during childbirth remains a powerful deterrent to skilled birth utilization.AimWe determined the perpetrated and witnessed experiences of mistreatment and Respectful Maternity Care (RMC) among maternal health providers in a tertiary hospital in Nigeria.MethodsA cross-sectional study was conducted among 156 maternal health providers in a tertiary hospital in Nigeria. Information was collected using semi-structured, self-administered questionnaires, and 3 focus group discussions. Quantitative and qualitative data analyses were performed using SPSS version 20 and thematic analysis respectively.FindingsMost respondents were males (64.1%) and doctors (74.4%) with mean age of 31.97 ± 6.82. Two-fifths (39.1%) and 73.1% of the respondents had ever meted out or witnessed disrespectful and abusive care to women during childbirth respectively. Verbal abuse and denial of companionship in labour were major mistreatments reported qualitatively and quantitatively. About a third of the respondents mistreated women 1–2 times in a week. Younger respondents had 64% lower odds of reporting mistreatment during childbirth (AOR = 0.36, 95% CI = 0.14−0.96). The most and least frequently practiced RMC element were provision of consented care (62.8%) and allowing birth position of choice respectively (3.8%). Poor hospital patronage and reputation were the perceived consequences of mistreatment during childbirth.ConclusionWitnessed rather than self-perpetrated mistreatment during childbirth was more reported in addition to poor RMC practices Self-perpetrated mistreatment during childbirth was less reported among younger providers. We recommend intensification of provider capacity building on RMC with special focus on older practitioners and the provision of supportive work environments that encourage respectful maternal care practices.     

Why do some health care providers disrespect and abuse women during childbirth in India?

BackgroundDisrespect and abuse during childbirth can result in fear of childbirth. Consequently, women may be discouraged to seek care, increasing the likelihood for women to choose elective cesarean section in order to avoid humiliation, postnatal depression and even maternal mortality. This study investigates the causes underlying mistreatment of women during childbirth by health care providers in India, where evidence of disrespect and abuse has been reported.MethodsQualitative research was undertaken involving 34 in-depth interviews with midwifery and nursing leaders from India who represent administration, advocacy, education, regulation, research and service provision at state and national levels. Data are analysed thematically with NVivo12. The analysis added value by bringing an international perspective from interviews with midwifery leaders from Switzerland and the United Kingdom.FindingsThe factors leading to disrespect and abuse of women relate to characteristics of both women and their midwives. Relevant woman-related attributes include her age, gender, physical appearance and education, extending to the social environment including her social status, family support, culture of abuse, myths around childbirth and sex-based discrimination. Midwife-related factors include gender, workload, medical hierarchy, bullying and powerlessness.DiscussionThe intersectionality of factors associated with mistreatment during childbirth operate at individual, infrastructural, social and policy levels for both the women and nurse-midwives, and these factors could exacerbate existing gender-based inequalities. Maternal health policies should address the complex interplay of these factors to ensure a positive birthing experience for women in India.ConclusionMaternal health interventions could improve by integrating women-centred protocols and monitoring measures to ensure respectful and dignified care during childbirth.