This archive report was first published on 2 August 2019.
Subtle Abuse Affects Women During Childbirth ¶
Published on August 2, 2019
Stripping women of dignity and respect during childbirth is not only a violation of human rights but also affects the health of women and babies. A growing body of research shows that while some women experience physical and verbal abuse, a much larger group experience more subtle forms of disrespectful care.
Studies have looked at abuse and disrespect in maternity care, but few have explored the range of issues that affect women's experiences in low- and middle-income countries. Researchers conducted in-depth interviews with 3,600 women in Kenya, Ghana, and India who had recently given birth. They found that communication was the area of care that was most lacking.
According to the researchers, the vast majority of women in these countries said that their healthcare providers never introduced themselves. Many women are not given information about their care and don't understand what is happening to them. Over half reported that providers did not explain the purpose of exams or procedures and never asked permission before performing them.
Leaving women in the dark about their care can be a frightening and alienating experience. One woman told the researchers, 'They did not tell me anything, I just saw the vehicle ready and they told me you are going to (the hospital) because you are going for an operation. That is the only thing I was told.'
Other simple things that were overlooked included how a woman was received when she arrived at the facility, and the timeliness of her care. Simple changes can be made at every level, from interpersonal interactions between women and their providers to the health systems at a national level.
The violations of basic rights would be enough to inspire action to remedy this problem. But it has even bigger implications for women's health. Negative experiences lead to a lack of trust and poor perceptions of the quality of care in health facilities. This discourages women from seeking health care.
According to the most recent data, about 300,000 women died in 2015 from pregnancy-related and childbirth causes. Almost all of those were in low- and middle-income countries. Mistreatment in health care settings has also been linked with poor outcomes for women such as post-traumatic stress disorder.
Researchers, practitioners, advocates, and policymakers must continue to work against abuse and more overt forms of disrespect. But making those the sole focus can make many providers and facilities complacent in thinking they are doing well just because they have not been overtly disrespectful.
