Measuring mistreatment of women throughout the birthing process

Implications for Quality of Care Assessments

Bibliographic Data

ID4787091
AuthorsTimothy Abuya (0000-0001-8815-8299, Associate, Population Council, Nairobi, Kenya, corresponding author), Pooja Sripad (0000-0002-1166-5564, Associate, Population Council, Washington, DC, 20008, USA), Julie Ritter (0000-0002-5979-1869, Program Manager, St. Jude Children’s Research Hospital, Memphis, TN, USA), Charity Ndwiga (0000-0001-9926-1486, Senior Program Officer, Population Council, Nairobi, Kenya), Charlotte E Warren (Senior Associate, Population Council, Washington, DC, 20008, USA), Charlotte Warren (0000-0002-1361-2618, Population Council)
Year2018
Volume26
Issue53
Pages48-61
Publication date2018-08-27
Open AccessYes
TypeARTICLE
VenueReproductive Health Matters (JOURNAL)
Journal identifiersISSN: 0968-8080 • E-ISSN: 1460-9576
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09688080.2018.1502018
PMID30212308
OpenAlexW2891256121
LanguageEN
Citations received6
References cited25

Measuring mistreatment and quality of care during childbirth is important in promoting respectful maternity care. We describe these dimensions throughout the birthing process from admission, delivery and immediate postpartum care. We observed 677 client-provider interactions and conducted 13 facility assessments in Kenya. We used descriptive statistics and logistic regression model to illustrate how mistreatment and clinical process of care vary through the birthing process. During admission, the prevalence of verbal abuse was 18%, lack of informed consent 59%, and lack of privacy 67%. Women with higher parity were more likely to be verbally abused [AOR: 1.69; (95% CI 1.03,2.77)]. During delivery, low levels of verbal and physical abuse were observed, but lack of privacy and unhygienic practices were prevalent during delivery and postpartum (>65%). Women were less likely to be verbally abused [AOR: 0.88 (95% CI 0.78, 0.99)] or experience unhygienic practices, [AOR: 0.87 (95% CI 0.78, 0.97)] in better-equipped facilities. During admission, providers were observed creating rapport (52%), taking medical history (82%), conducting physical assessments (5%). Women's likelihood to receive a physical assessment increased with higher infrastructural scores during admission [AOR: 2.52; (95% CI 2.03, 3.21)] and immediately postpartum [AOR 2.18; (95% CI 1.24, 3.82)]. Night-time deliveries were associated with lower likelihood of physical assessment and rapport creation [AOR; 0.58; (95% CI 0.41,0.86)]. The variability of mistreatment and clinical quality of maternity along the birthing process suggests health system drivers that influence provider behaviour and health facility environment should be considered for quality improvement and reduction of mistreatment

Alternative medicine · Childbirth · Descriptive statistics · Family medicine · Health care · Informed consent · Logistic regression · Medical emergency · Physical abuse · Poison control · Postpartum period · Pregnancy · Sexual abuse · Suicide prevention · Verbal abuse · Global Maternal and Child Health · Grief, Bereavement, and Mental Health · Maternal and Perinatal Health Interventions · Medicine · Nursing

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