Disrespect and abuse in maternity care

Individual Consequences of Structural Violence

Bibliographic Data

ID3972924
AuthorsAndrea Solnes Miltenburg (0000-0003-4681-7043, University of Oslo, corresponding author), Sandra Van Pelt (0000-0003-3311-3848, Registered Nurse, Project Coordinator at Women Centered Care Project, African Woman Foundation, Mwanza Region, Tanzania), Tarek Meguid (0000-0001-6873-2580, Consultant Obstetrician and Gynecologist, Department of Obstetrics & Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania), Johanne Sundby (0000-0002-6603-0515, University of Oslo)
Year2018
Volume26
Issue53
Pages88-106
Publication date2018-08-27
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueReproductive Health Matters (JOURNAL)
Journal identifiersISSN: 0968-8080 • E-ISSN: 1460-9576
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09688080.2018.1502023
PMID30132403
OpenAlexW2888713690
LanguageEN
Citations received24
References cited35

Disrespect and abuse of patients, especially birthing women, does occur in the health sector. This is a violation of women's fundamental human rights and can be viewed as a consequence of women's lives not being valued by larger social, economic and political structures. Here we demonstrate how such disrespect and abuse is enacted at an interpersonal level across the continuum of care in Tanzania. We describe how and why women's exposure to disrespect and abuse should be seen as a symptom of structural violence. Detailed narratives were developed based on interviews and observations of 14 rural women's interactions with health providers from their first antenatal visit until after birth. Narratives were based on observation of 25 antenatal visits, 3 births and 92 in-depth interviews with the same women. All women were exposed to non-supportive care during pregnancy and birth including psychological abuse, physical abuse, abandonment and privacy violations. Systemic gender inequality renders women excessively vulnerable to abuse, expressed as a normalisation of abuse in society. Health institutions reflect and reinforce dominant social processes and normalisation of non-supportive care is symptomatic of an institutional culture of care that has become dehumanised. Health providers may act disrespectfully because they are placed in a powerful position, holding authority over their patients. However, they are themselves also victims of continuous health system challenges and poor working conditions. Preventing disrespect and abuse during antenatal care and childbirth requires attention for structural inequalities that foster conditions that make mistreatment of vulnerable women possible

Domestic violence · Health care · Medical emergency · Physical abuse · Poison control · Political science · Psychiatry · Suicide prevention · Global Maternal and Child Health · Grief, Bereavement, and Mental Health · Maternal and Perinatal Health Interventions · Medicine · Nursing · Psychology

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