Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana

D’Ambruoso, Lucia; Abbey, Mercy; Hussein, Julia

doi:10.1186/1471-2458-5-140

Cited by 202 publications

(245 citation statements)

References 35 publications

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“…On the other hand, women referred to a health facility as a result of life-threatening complications may feel gratitude and therefore downplay their reporting of incidents of D and A [9,12,27]. However, we cannot say whether this is true or not from these data.…”

Section: Discussionmentioning

confidence: 96%

“…When women are well informed about the procedures they are required to undergo, their compliance with safety instructions is likely to be higher. They are also more likely to feel respected and come away with positive feelings about their childbirth experiences [9,22]. …”

Section: Discussionmentioning

confidence: 99%

“…This gave women more freedom to express their feelings and report positive and negative experiences without fear, and eliminated social desirability bias [9]. The use of health extension workers who were known to the women and their communities was a factor in the study achieving a 100% response rate.…”

Section: Discussionmentioning

confidence: 99%

“…Only women who gave birth to live babies were included and therefore the study excluded stillbirths, neonatal and infant deaths. It is possible that those women may have had negative experiences of D and A, but this cannot be established from these data [9]. …”

Section: Discussionmentioning

confidence: 99%

“…As a result, this topic has been either ignored or under-reported [8]. Disrespectful and abusive care includes impoliteness of care providers, inappropriate reprimands, shouting at the client, lack of empathy, refusal to assist, threatening clients for their non-compliance, and denying clients opportunities to choose or give an opinion on the care they are receiving [9–11]. In recent years, the issue has received greater attention due to improved methods to operationally define and measure the phenomena [12–14].…”

Section: Introductionmentioning

confidence: 99%

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Mothers’ experience of disrespect and abuse during maternity care in northern Ethiopia

Gebremichael

Worku

Medhanyie

et al. 2018

Global Health Action

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Background: The provision of respectful and satisfactory maternity care is essential for promoting timely care-seeking behaviour, and ultimately ensuring the health and well-being of mothers and their babies. Disrespectful and abusive care has been recognized as one of the barriers to seeking timely maternity health services. However, the issue has not been adequately researched in community settings in low- and middle-income countries using validated measurement tools. Objective: This study was conducted to assess the extent of, and factors associated with, disrespectful and abusive maternity care reported by women who utilized facility-based delivery services in northern Ethiopia. Methods: We conducted a community-based cross-sectional study in Tigray, northern Ethiopia. Women who gave birth in the preceding year and visited health institutions for these deliveries were selected using a multistage cluster sampling procedure. Data were collected using a pretested questionnaire. Six domains of disrespect and abuse (D and A) were included in the questionnaire. Socio-demographic and obstetric related factors associated with D and A were tested using a negative binomial regression model. Results: Of the 1125 women in the sample, 248 (22%; 95% CI: 19.8%, 24.4%) reported at least one incident of D and A during delivery at a public health facility in northern Ethiopia. Higher incidents of D and A were reported by women who were older than 19 years at the time of delivery (aIRR = 2.649 (95% CI: 1.455, 4.825) compared to younger women. Incidents of D and A were reported more by women residing in urban areas, by women educated to the ninth grade and above, by women who experienced longer labour duration, and also by women who were not permitted to have support persons attend labour and delivery. Conclusions: A fifth of the women reported D and A while receiving care during labour and delivery. Policies and practices aimed at ensuring universal coverage for institutional deliveries need to promote respectful maternity care for women in all facilities.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mothers’ experience of disrespect and abuse during maternity care in northern Ethiopia

Gebremichael

Worku

Medhanyie

et al. 2018

Global Health Action

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How Midwives Should Organise to Provide Intrapartum Care

McCourt

2010

Essential Midwifery Practice: Intrapartum Care

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Stakeholders' views on maternity care shortcomings in rural Ghana: An ethnographic study among women, providers, public, and quasiprivate policy sector actors

Ayanore

Pavlova

Biesma

et al. 2017

Health Planning & Management

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Access to skilled provider and emergency obstetric care is not universal across all districts in Ghana. The lived experiences of 3 stakeholder groups on maternity care shortcomings in 3 rural Ghanaian districts are examined in this study. We applied an ethnographic study approach where field data were collected between March to May 2015 in 3 rural districts of northern Ghana. Data were collected among women with recent births experiences (n = 90), health care providers (n = 16), and policy actors (n = 6). Transcripts were read through to identify similar and divergent stakeholders' views. Significant expressions and experiences of stakeholders on maternity care shortcomings were extracted and evaluated to define key themes. Four themes emerged: social/community factors, payments for health care, facility level factors, and policy level factors. The results show that traditional women's roles divest time for maternity care. Poor transport arrangements, insufficient health workforce, health funding gaps, insurance reimbursements delays, and catastrophic health expenditures on travel and drugs are attested as major barriers across all stakeholder groups in all districts studied. The discussion of the study findings suggests it is important to ascertain the scale of informal payments and their impacts on health access. Investments in health workforce and reliable ambulatory service systems could help address poor referral difficulties in rural areas of the country. Social support for community initiatives that pool funds could provide extra resources and relieve cost access-related challenges for using maternity care in rural settings in Ghana.

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Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana

Abstract: Background: This study was undertaken to investigate women's accounts of interactions with health care providers during labour and delivery and to assess the implications for acceptability and utilisation of maternity services in Ghana.

Cited by 202 publications

References 35 publications

Mothers’ experience of disrespect and abuse during maternity care in northern Ethiopia

Mothers’ experience of disrespect and abuse during maternity care in northern Ethiopia

How Midwives Should Organise to Provide Intrapartum Care

Stakeholders' views on maternity care shortcomings in rural Ghana: An ethnographic study among women, providers, public, and quasiprivate policy sector actors

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