Respectful maternity care is a universal human right that recognizes women’s preferences and the needs of mothers and newborns. A form of respectful maternity care is skilled assistance which is a key intervention in reducing maternal morbidity and mortality. However, studies show that women continue to experience different forms of disrespect and abuse (DRA) in healthcare institutions, namely: physical abuse, non-consented care, non-confidential care, non-dignified care, discrimination based on patient’s attributes, abandonment of care, and detention in facilities.
Abundant reports show the connection between disrespectful and abusive care during facility-based childbirth and the decision by women not to use facility-based childbirth services. Women in low and middle-income countries fear various undesirable procedures and may prefer to deliver at home with a traditional birth attendant rather than experience inadequate and disrespectful care from skilled birth attendants in healthcare facilities. Negative patient experiences at health institutions contribute to poor health outcomes and reinforce mistrust of institutional care, thus making women delay or avoid seeking care in health facilities, which risks their health and that of their newborn. This shows the detrimental effect DRA has on skilled delivery attendance during childbirth and remains a hindrance in achieving increased utilization of services, and enhanced RMC and maternal well-being.
To assess the respectful maternity care or RMC being provided to childbearing women during labor and childbirth, researchers conducted a cross-sectional study on women who gave birth at health institutions in the West Shewa zone, Central Ethiopia. As indicated, disrespect and abuse during labor and childbirth is an important concern, especially in countries like Ethiopia, where the maternal mortality rate is high while the skilled birth attendance has been very low. Data was collected through a pre-exit interview using a pre-tested structured questionnaire. Upon analyzing the data, the researchers discovered that among the 567 respondents, the number of women who received RMC during labor and childbirth was only 203 (35.8%) or ⅓ of the overall sample population, while 364 (64.2%) had experienced disrespect and abusive care during childbirth.
The study revealed that RMC during labor and childbirth in health institutions in the west Shewa zone was low. However, various factors such as giving birth at a health center instead of a general hospital, daytime delivery, discussion on the place of delivery with health workers during antenatal care, long duration of stay at the health facility, involvement in decision-making, acknowledgment to women’s right to information, current pregnancy not wanted, getting consent before the procedure, less than 3 healthcare workers present during childbirth, and satisfaction with waiting time to be seen by a health worker all have positive significant correlations with RMC.
Therefore, health institutions should emphasize creating awareness on the standards and categories of RMC among care providers, and emphatically consider those identified factors for intervention. Furthermore, monitoring and reinforcing accountability mechanisms for health workers should be promoted to avoid abuse, negligence, and mistreatment; and provide maternal care and service with respect and compassion to make labor and childbirth a safe and positive experience for both the mother and baby.
Reference:
Bulto, G. A., Demissie, D. B., & Tulu, A. S. (2020). Respectful maternity care during labor and childbirth and associated factors among women who gave birth at health institutions in the West Shewa zone, Oromia region, Central Ethiopia. BMC Pregnancy and Childbirth, 20(1). https://doi.org/10.1186/s12884-020-03135-z.