Labour companionship and women’s experiences of mistreatment during childbirth: results from a multi-country community-based survey

Baldé, Mamadou Diouldé; Nasiri, Khalidha; Mehrtash, Hedieh; Soumah, Abdoul Karim; Bohren, Meghan A.; Diallo, Boubacar Alpha; Irinyenikan, Theresa Azonima; Maung, Thae Maung; Thwin, Soe Soe; Aderoba, Adeniyi Kolade; Vogel, Joshua P.; Mon, Nwe Oo; Adu‐Bonsaffoh, Kwame; Tunçalp, Özge

doi:10.1136/bmjgh-2020-003564

Cited by 29 publications

(38 citation statements)

References 33 publications

(89 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings from the labour observations are consistent with the community survey data within the same WHO multicountry study, which showed that the association between some types of mistreatment (ie, physical abuse, verbal abuse, poor communication and the absence of a labour companion) also varied by country. 29 Absence of a labour companion was associated with non-consented vaginal examination in Ghana and Guinea but not Nigeria, which only showed a significant association with decreased waiting time. 29 In this study, non-consented vaginal examination was generally high across all the three countries, ranging from approximately 50% in Guinea to nearly 70% in Nigeria.…”

Section: Discussionmentioning

confidence: 90%

Vaginal examinations and mistreatment of women during facility-based childbirth in health facilities: secondary analysis of labour observations in Ghana, Guinea and Nigeria

et al. 2021

Self Cite

View full text Add to dashboard Cite

BackgroundPrevious research on mistreatment of women during childbirth has focused on physical and verbal abuse, neglect and stigmatisation. However, other manifestations of mistreatment, such as during vaginal examinations, are relatively underexplored. This study explores four types of mistreatment of women during vaginal examinations: (1) non-consented care, (2) sharing of private information, (3) exposure of genitalia and (4) exposure of breasts.MethodsA secondary analysis of data from the WHO multicountry study ‘How Women Are Treated During Childbirth’ was conducted. The study used direct, continuous labour observations of women giving birth in facilities in Ghana, Guinea and Nigeria. Descriptive and multivariable logistic regression analyses were used to describe the different types of mistreatment of women during vaginal examinations and associated privacy measures (ie, availability of curtains).ResultsOf the 2016 women observed, 1430 (70.9%) underwent any vaginal examination. Across all vaginal examinations, 842/1430 (58.9%) women were observed to receive non-consented care; 233/1430 (16.4%) women had their private information shared; 397/1430 (27.8%) women had their genitalia exposed; and 356/1430 (24.9%) had their breasts exposed. The observed prevalence of mistreatment during vaginal examinations varied across countries. There were country-level differences in the association between absence of privacy measures and mistreatment. Absence of privacy measures was associated with sharing of private information (Ghana: adjusted OR (AOR) 3.8, 95% CI 1.6 to 8.9; Nigeria: AOR 4.9, 95% CI 1.9 to 12.7), genitalia exposure (Ghana: AOR 6.7, 95% CI 2.9 to 14.9; Nigeria: AOR 6.5, 95% CI 2.9 to 14.5), breast exposure (Ghana: AOR 5.9, 95% CI 2.8 to 12.9; Nigeria: AOR 2.7, 95% CI 1.3 to 5.9) and non-consented vaginal examination (Ghana: AOR 2.5, 95% CI 1.4 to 4.7; Guinea: AOR 0.21, 95% CI 0.12 to 0.38).ConclusionOur results highlight the need to ensure better communication and consent processes for vaginal examination during childbirth. In some settings, measures such as availability of curtains were helpful to reduce women’s exposure and sharing of private information, but context-specific interventions will be required to achieve respectful maternity care globally.

show abstract

Section: Discussionmentioning

confidence: 90%

Vaginal examinations and mistreatment of women during facility-based childbirth in health facilities: secondary analysis of labour observations in Ghana, Guinea and Nigeria

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…This analysis as well as other in depth analyses of the study findings have identified substantial differences in how mistreatment is experienced in distinct healthcare settings and how forms of mistreatment may be linked. 54 As a whole, this body of work confirms that mistreatment is complex and cannot be measured by only one or two items standardised across populations and health system settings. Interventions to reduce mistreatment will require context-specific understanding of mechanisms and drivers within the health system.…”

Section: Discussionmentioning

confidence: 68%

Women’s report of mistreatment during facility-based childbirth: validity and reliability of community survey measures

et al. 2021

Self Cite

View full text Add to dashboard Cite

BackgroundAccountability for mistreatment during facility-based childbirth requires valid tools to measure and compare birth experiences. We analyse the WHO ‘How women are treated during facility-based childbirth’ community survey to test whether items mapping the typology of mistreatment function as scales and to create brief item sets to capture mistreatment by domain.MethodsThe cross-sectional community survey was conducted at up to 8 weeks post partum among women giving birth at hospitals in Ghana, Guinea, Myanmar and Nigeria. The survey contained items assessing physical abuse, verbal abuse, stigma, failure to meet professional standards, poor rapport with healthcare workers, and health system conditions and constraints. For all domains except stigma, we applied item-response theory to assess item fit and correlation within domain. We tested shortened sets of survey items for sensitivity in detecting mistreatment by domain. Where items show concordance and scale reliability ≥0.60, we assessed convergent validity with dissatisfaction with care and agreement of scale scores between brief and full versions.Results2672 women answered over 70 items on mistreatment during childbirth. Reliability exceeded 0.60 in all countries for items on poor rapport with healthcare workers and in three countries for items on failure to meet professional standards; brief scales generally showed high agreement with longer versions and correlation with dissatisfaction. Brief item sets were ≥85% sensitive in detecting mistreatment in each country, over 90% for domains of physical abuse and health system conditions and constraints.ConclusionBrief scales to measure two domains of mistreatment are largely comparable with longer versions and can be informative for these four distinct settings. Brief item sets efficiently captured prevalence of mistreatment in the five domains analysed; stigma items can be used and adapted in full. Item sets are suitable for confirmation by context and implementation to increase accountability and inform efforts to eliminate mistreatment during childbirth.

show abstract

“…Another attitude identified by the participants in this study was that a relative should accompany the woman in case of complications during pregnancy or childbirth. It represents a major psychological support for the woman in labor [22]. According to Peprah et al [21], acceptance of support is easier when the delivery is carried out by a traditional birth attendant.…”

Section: ) Knowledgementioning

confidence: 99%

Women’s Knowledge and Attitudes about Complications during Pregnancy and Childbirth in Guinea

Baldé¹,

Diallo²,

Touré³

et al. 2021

OJOG

Self Cite

View full text Add to dashboard Cite

Introduction: Maternal mortality remains a major public health problem in the world. Complications during pregnancy and childbirth are the main causes of maternal mortality in low-income countries. It is estimated that 15% of deaths are related to these complications. Studies have shown that women have little or no acquaintance on sign danger and complications during pregnancy and childbirth. Limited literature exists on women's knowledge and attitudes about pregnancy and childbirth's complications as well as the barriers for their management, therefore necessity to carry out this study. Objective: To explore women's knowledge and attitudes in the community about complications during pregnancy and childbirth. Method: A qualitative study was conducted in three prefectures of Guinea. Eighteen focus groups were conducted with women of reproductive age living in urban and rural areas. Results: Complications during pregnancy and childbirth are common among pregnant women in Guinea. Many women have knowledge about various sorts of complications related to pregnancy and childbirth. These complications were mostly vaginal bleeding, abortions and maternal mortality. The use of a health facility in case of complications during pregnancy and childbirth was reported as a major attitude in this study. Accompanying the woman to the health facility was another attitude identified. Lack of financial means, the distance from the health facilities and the lack of means of transport were listed as barriers to the management of complications during pregnancy and childbirth. Conclusion: This study showed that women's knowledge and attitudes about obstetric complications are insufficient. To that effect, women counselling during prenatal consultations on the risks of complications and How to cite this paper:

show abstract

Labour companionship and women’s experiences of mistreatment during childbirth: results from a multi-country community-based survey

Cited by 29 publications

References 33 publications

Vaginal examinations and mistreatment of women during facility-based childbirth in health facilities: secondary analysis of labour observations in Ghana, Guinea and Nigeria

Vaginal examinations and mistreatment of women during facility-based childbirth in health facilities: secondary analysis of labour observations in Ghana, Guinea and Nigeria

Women’s report of mistreatment during facility-based childbirth: validity and reliability of community survey measures

Women’s Knowledge and Attitudes about Complications during Pregnancy and Childbirth in Guinea

Contact Info

Product

Resources

About