Respect to Women’s Autonomy in Childbirth: A Qualitative Study

Rabor, Firoozeh Mirzaee; Taghipour, Ali; Najmabadi, Khadigeh Mirzaii; Masoum, Seyed Hosein Fattahi; Fazilat-Pour, Masoud

doi:10.5812/ircmj.29344

Cited by 3 publications

(2 citation statements)

References 33 publications

(26 reference statements)

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“…It has also been reported that mobility during the first stage of labour is safe 38. Denying women autonomy, or not respecting women’s choices during childbirth without a justifiable medical reason, constitutes mistreatment that negatively affects their overall childbirth experience 42…”

Section: Discussionmentioning

confidence: 99%

Organisational and individual readiness for change to respectful maternity care practice and associated factors in Ibadan, Nigeria: a cross-sectional survey

2022

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ObjectivesThis study assessed health providers’ organisational and individual readiness for change to respectful maternity care (RMC) practice and their associated factors in Ibadan Metropolis, Nigeria.DesignA cross-sectional survey using standardised structured instruments adapted from the literature.SettingNine public health facilities in Ibadan Metropolis, Nigeria, 1 December 2019–31 May 2020.Participants212 health providers selected via a two-stage cluster sampling.OutcomesOrganisational readiness for change to RMC (ORCRMC) and individual readiness for change to RMC (IRCRMC) scales had a maximum score of 5. Multiple linear regression was used to identify factors influencing IRCRMCand ORCRMC.We evaluated previously identified predictors of readiness for change (change valence, informational assessments on resource adequacy, core self-evaluation and job satisfaction) and proposed others (workplace characteristics, awareness of mistreatment during childbirth, perceptions of women’s rights and resource availability to implement RMC). Data were adjusted for clustering and analysed using Stata V.15.ResultsThe providers’ mean age was 44.0±9.9 years with 15.4±9.9 years of work experience. They scored high on awareness of women’s mistreatment (3.9±0.5) and women’s perceived rights during childbirth (3.9±0.5). They had high ORCRMC(4.1±0.9) and IRCRMC(4.2±0.6), both weakly but positively correlated (r=0.407, 95% CI: 0.288 to 0.514, p<0.001). Providers also had high change valence (4.5±0.8) but lower perceptions of resource availability (2.7±0.7) and adequacy for implementation (3.3±0.7). Higher provider change valence and informational assessments were associated with significantly increased IRCRMC(β=0.40, 95% CI: 0.11 to 0.70, p=0.015 and β=0.07, 95% CI: 0.01 to 0.13, p=0.032, respectively), and also with significantly increased ORCRMC(β=0.47, 95% CI: 0.21 to 0.74, p=0.004 and β=0.43, 95% CI: 0.22 to 0.63, p=0.002, respectively). Longer years of work experience (β=0.08, 95% CI: 0.01 to 0.2, p=0.024), providers’ monthly income (β=0.08, 95% CI: 0.02 to 0.15, p=0.021) and the health facility of practice were associated with significantly increased ORCRMC.ConclusionThe health providers studied valued a change to RMC and believed that both they and their facilities were ready for the change to RMC practice.

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Section: Discussionmentioning

confidence: 99%

Organisational and individual readiness for change to respectful maternity care practice and associated factors in Ibadan, Nigeria: a cross-sectional survey

2022

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“…In most studies, the social context appears to be a crucial determinant of the impact of empowerment on women's health and well-being throughout the childbirth process [13][14][15]. One study that focused on vaginal delivery demonstrated the difficulty of ensuring that women's autonomy is respected and the crucial role of women's empowerment in childbirth regarding access to information, the presentation of self-assertion and a woman's relationship with midwives [16]. One cause of high rates of CS that is linked to women's empowerment is women's request for CS, which reaches a high level in middle-income countries [17].…”

Section: Introductionmentioning

confidence: 99%

Women’s empowerment and elective cesarean section for a single pregnancy: a population-based and multivariate study in Vietnam

Loenzien

Mac

Dumont

2021

BMC Pregnancy Childbirth

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Background Women’s empowerment, and maternal and neonatal health are important targets of the Sustainable Development Goals. Our objective is to examine the relationship between women’s empowerment and elective cesarean section (ECS), focusing on Vietnam, a country where the use of CS has increased rapidly in recent decades, which raises public health concerns. Methods We hypothesized that in the context of the developing biomedicalization of childbirth, women’s empowerment increases the use of ECS due to a woman’s enhanced ability to decide her mode of delivery. By using microdata from the 2013–2014 Multiple Indicator Clusters Survey, we conducted a multivariate analysis of the correlates of ECS. We studied a representative sample of 1343 institutional single birth deliveries. Due to higher ECS rates among multiparous (18.4%) than primiparous women (10.1%) and the potential interaction between parity and other correlates, we used separate models for primiparous and multiparous women. Results Among the indicators of women’s external resources, which include a higher level of education, having worked during the previous 12 months, and having one’s own mobile phone, only education differed between primiparous and multiparous women, with a higher level among primiparous women. Among primiparous women, no resource indicator was significantly linked to ECS. However, considering women’s empowerment facilitated the identification of the negative impact of having had fewer than 3 antenatal care visits on the use of ECS. Among multiparous women, disapproval of intimate partner violence (IPV) was associated with a doubled likelihood of undergoing ECS (odds ratio = 2.415), and living in an urban area also doubled the likelihood of ECS. The positive association with living in the richest household quintile was no longer significant when attitude towards IPV was included in the model. In both groups, being aged 35 or older increased the likelihood of undergoing ECS, and this impact was stronger in primiparous women. Conclusions These results underline the multidimensionality of empowerment, its links to other correlates and its contribution to clarifying the influence of these correlates, particularly for distinguishing between medical and sociocultural determinants. The results advocate for the integration of women's empowerment into policies aimed at reducing ECS rates.

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