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Introduction Disrespect and abuse of women during childbirth is one of the deterring factors to skilled childbirth utilization, especially in low and middle-income countries. Objective The objective of this study was to assess the prevalence of women’s disrespect and abuse during childbirth in public health facilities in Arba Minch town, south Ethiopia. Methods Institution-based cross-sectional study design was employed at all public health institutions in Arba Minch town, south Ethiopia. A systematic random sampling method was used to include 281 women who had given birth at public health institutions between January 01 and February 28, 2017. Data were collected through face to face interview by four data collectors and they were supervised by the principal investigator during the entire period of data collection. A semi-structured pretested questionnaire was used to collect the data. Epi info version 7.1.2.0 and SPSS version 24 were used to enter and analyze the data, respectively. Results The overall prevalence of non-respectful care was 98.9%. The women’s right to information and informed consent was the most frequently violated right with a prevalence of 92.5% (95% CI: 90.9, 94.1) followed by non-dignified care (36.7, 95% CI: 34.9, 38.5), physical abuse (29.5%, 95% CI: 24.2, 34.8), discrimination (18.1%, 95% CI: 13.6, 22.6), non-confidential care (17.1%, 95% CI: 12.7, 21.5) and abandonment of care (4.3%, 95% CI: 3.1, 5.5). Rural residence, giving birth in the hospital, having no or low educational status and giving birth by cesarean route were factors significantly associated with specific women’s rights violations. Conclusions and recommendations The prevalence of women’s disrespect and abuse during childbirth at the health care facilities in this study area is very high. Therefore, health managers need to work hard to tackle the problem.

Background Fear of childbirth is one of the life challenges the women encounter during pregnancy. It is an important source of distress for the women and their families and also increases the odds of obstetric complications during childbirth. The aim of this study was to assess the magnitude of fear of childbirth and associated factors among pregnant women attending antenatal care at public health facilities in Arba Minch town, southern Ethiopia. Methods Institution-based cross-sectional study was carried out among pregnant women who attended antenatal care at public health facilities in Arba Minch from November 1st − 30th 2019. A systematic random sampling technique was employed to include the participants. Data were collected through a face-to-face interview by using a structured and pretested questionnaire. Wijma Delivery Expectancy Questionnaire was used to score fear of childbirth. Epi Data version 3.1 and Statistical Package for the Social Sciences version 25.0 software were used for data management. Descriptive and analytic analyses were done and statistical significance was declared at a p-value < 0.05 and 95% confidence level in multivariable analysis. Results A total of 387 pregnant women have participated in this study. Forty (10.3%) of the pregnant women had a low degree fear, 154(39.8%) had a moderate degree fear, 98(25.3%) had a high degree fear, and 95(24.5%) had severe degree fear of childbirth. Unplanned pregnancy (AOR = 2.30, 95% CI: 1.12, 4.74), current pregnancy-related complications (AOR = 6.24, 95% CI: 2.72, 14.29), and poor social support (AOR = 1.93, 95%CI: 1.01, 3.68) were factors significantly associated with severe degree fear of childbirth. Conclusions Almost three-fourth of the pregnant women in this study area had moderate to severe degree fear of childbirth. Tailoring counseling during antenatal care visits is needed to address those women who are at a high risk of considerable childbirth fear and its health consequences.

21Introduction: Disrespect and abuse during childbirth is the main deterring factor to skilled birth 22 utilization as compared to other more commonly known factors such as financial and physical 23 inaccessibility. 24 Objective: To assess the occurrence of women's disrespect and abuse during childbirth in public health 25 facilities in Arba Minch town, south Ethiopia. 26 Methods: Institution based cross-sectional study design was employed at all public health institutions in 27 Arba Minch town, south Ethiopia. Systematic sampling method was used to include 281 women who had 28 given birth at public health institutions between January 01 and February 28, 2017. Data were collected 29 by face to face interview by four midwife tutors and supervised by the principal investigator on daily 30 bases. Semi-structured pretested questionnaire was used to collect data. Epi info version 7.1.2.0 and SPSS 31 version 24 were used to enter and analyze the data respectively. 32 Results: A total of 281 women were participated in this study. The overall prevalence of non-respectful 33 care was 98.9%. The women's right to information and informed consent was the most frequently 34 violated right with a prevalence of 92.5% (95% CI: 90.9, 94.1) followed by non-dignified care (36.7, 95% 35 CI: 34.9, 38.5), physical abuse (29.5%, 95% CI: 24.2, 34.8), discrimination (18.1%, 95% CI: 13.6, 22.6), 36non-confidential care (17.1%, 95% CI: 12.7, 21.5) and abandonment of care (4.3%, 95% CI: 3.1, 5.5). 37However, there is no woman who had been kept in detention in the health facilities. Being rural resident, 38giving birth in hospital, having no or low educational status and giving birth by cesarean route were 39 factors which were significantly associated with specific women's rights violations.3 40 Conclusions and recommendations:The status of non-respectful and abusive care in the health 41 care facilities in this study area is unacceptably high and needs serious attention by the health managers to 42 tackle the problem. 43