Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2021

Open Access 01-12-2021 | Care | Research article

Does disrespect and abuse during childbirth differ between public and private hospitals in Southeast Nigeria

Authors: Ijeoma Nkem Okedo-Alex, Ifeyinwa Chizoba Akamike, Irene Ifeyinwa Eze, Chika Nwamma Onwasigwe

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Login to get access

Abstract

Background

Disrespect and Abuse (D&A) during childbirth represents an important barrier to skilled birth utilization, indicating a problem with quality of care and a violation of women‘s human rights. This study compared prevalence of D&A during childbirth in a public and a private hospital in Southeast Nigeria.

Methods

This study was a cross-sectional study among women who gave birth in two specialized health facilities: a public teaching and a private-for-profit faith-based hospital in Southeast Nigeria. In each facility, systematic random sampling was used to select 310 mothers who had given birth in the facility and were between 0-14 weeks after birth. Study participants were recruited through the immunization clinics. Semi-structured, interviewer-administered questionnaires using the Bowser and Hills classification of D&A during childbirth were used for data collection. Data were analyzed using SPSS version 20 at 95% significance level.

Results

Mean age of the participants in the public hospital was 30.41 ± 4.4 and 29.31 ± 4.4 in the private hospital. Over three-fifths (191; 61.6%) in the public and 156 women (50.3%) in the private hospital had experienced at least one form of D&A during childbirth [cOR1.58; 95% CI 1.15, 2.18]. Abandonment and neglect [Public153 (49.4%) vs. Private: 91 (29.4%); cOR2.35; 95% CI. 1.69, 3.26] and non-consented care [Public 45 (14.5%) vs. Private 67(21.6%): cOR0.62; 95% CI. 0.41, 0.93] were the major types of D&A during childbirth. Denial of companionship was the most reported subtype of D&A during childbirth in both facilities [Public 135 (43.5%) vs. Private66 (21.3%); cOR2.85; 95% CI. 2.00, 4.06]. Rural residents were less likely to report at least one form of D&A during childbirth (aOR 0.53; CI 0.35-0.79).

Conclusion

Although prevalence was high in both facilities, overall prevalence of D&A during childbirth and most subtypes were higher in the public health facility. There is a need to identify contextual factors enabling D&A during childbirth in public and private health care settings.
Appendix
Available only for authorised users
Literature
5.
go back to reference Miller S, Lalonde A. The global epidemic of abuse and disrespect during childbirth : History , evidence , interventions , and FIGO ’ s mother − baby friendly birthing facilities initiative. Int J Gynecol Obstet. 2015;131:S49–52.CrossRef Miller S, Lalonde A. The global epidemic of abuse and disrespect during childbirth : History , evidence , interventions , and FIGO ’ s mother − baby friendly birthing facilities initiative. Int J Gynecol Obstet. 2015;131:S49–52.CrossRef
6.
go back to reference Hameed W, Avan BI. Women’s experiences of mistreatment during childbirth: A comparative view of home- and facility-based births in Pakistan. PLoS One. 2018;13:e0194601.PubMedPubMedCentralCrossRef Hameed W, Avan BI. Women’s experiences of mistreatment during childbirth: A comparative view of home- and facility-based births in Pakistan. PLoS One. 2018;13:e0194601.PubMedPubMedCentralCrossRef
7.
go back to reference Bohren MA, Vogel JP, Hunter EC, et al. The Mistreatment of Women during Childbirth in Health Facilities Globally : A Mixed-Methods Systematic Review. PLos Med. 2015;12:1–32.CrossRef Bohren MA, Vogel JP, Hunter EC, et al. The Mistreatment of Women during Childbirth in Health Facilities Globally : A Mixed-Methods Systematic Review. PLos Med. 2015;12:1–32.CrossRef
9.
go back to reference National Population Commission (NPC) [Nigeria] and The DHS Program ICF Rockville, Maryland U. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria and Rockville, Maryland, USA, 2019. National Population Commission (NPC) [Nigeria] and The DHS Program ICF Rockville, Maryland U. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria and Rockville, Maryland, USA, 2019.
10.
11.
go back to reference Uwakwe KA, Merenu IA, Duru CB, et al. Patterns of utilization of orthodox and / or traditional healthcare services among pregnant women and mothers of under - five children in a rural community : Case study of Njaba , Imo State, Nigeria. Sahel Med J. 2015;18:103–8.CrossRef Uwakwe KA, Merenu IA, Duru CB, et al. Patterns of utilization of orthodox and / or traditional healthcare services among pregnant women and mothers of under - five children in a rural community : Case study of Njaba , Imo State, Nigeria. Sahel Med J. 2015;18:103–8.CrossRef
12.
go back to reference Freedman L, Kruk M. Disrespect and abuse of women in childbirth : challenging the global quality and accountability agendas. Lancet. 2014;384:e42–4.PubMedCrossRef Freedman L, Kruk M. Disrespect and abuse of women in childbirth : challenging the global quality and accountability agendas. Lancet. 2014;384:e42–4.PubMedCrossRef
13.
go back to reference Mselle LT, Moland KM, Mvungi A, et al. Why give birth in health facility? users’ and providers’ accounts of poor quality of birth care in Tanzania. BMC Health Serv Res. 2013;13:174.PubMedPubMedCentralCrossRef Mselle LT, Moland KM, Mvungi A, et al. Why give birth in health facility? users’ and providers’ accounts of poor quality of birth care in Tanzania. BMC Health Serv Res. 2013;13:174.PubMedPubMedCentralCrossRef
14.
go back to reference Roro MA, Hassen EM, Lemma AM, et al. Why do women not deliver in health facilities : a qualitative study of the community perspectives in south central Ethiopia? BMC Res Notes. 2014;7:1–7.CrossRef Roro MA, Hassen EM, Lemma AM, et al. Why do women not deliver in health facilities : a qualitative study of the community perspectives in south central Ethiopia? BMC Res Notes. 2014;7:1–7.CrossRef
15.
go back to reference Bohren MA, Hunter EC, Munthe-kaas HM, et al. Facilitators and barriers to facility-based delivery in low- and middle-income countries: a qualitative evidence synthesis. Reprod Health. 2014;11:71.PubMedPubMedCentralCrossRef Bohren MA, Hunter EC, Munthe-kaas HM, et al. Facilitators and barriers to facility-based delivery in low- and middle-income countries: a qualitative evidence synthesis. Reprod Health. 2014;11:71.PubMedPubMedCentralCrossRef
16.
go back to reference Sychareun V, Hansana V, Somphet V, et al. Reasons rural Laotians choose home deliveries over delivery at health facilities : a qualitative study. BMC Pregnancy Childbirth. 2012;12:86.PubMedPubMedCentralCrossRef Sychareun V, Hansana V, Somphet V, et al. Reasons rural Laotians choose home deliveries over delivery at health facilities : a qualitative study. BMC Pregnancy Childbirth. 2012;12:86.PubMedPubMedCentralCrossRef
17.
go back to reference Wilunda C, Scanagatta C, Putoto G, et al. Barriers to Institutional Childbirth in Rumbek North County , South Sudan : A Qualitative Study. PLoS One. 2016;11:e0168083.PubMedPubMedCentralCrossRef Wilunda C, Scanagatta C, Putoto G, et al. Barriers to Institutional Childbirth in Rumbek North County , South Sudan : A Qualitative Study. PLoS One. 2016;11:e0168083.PubMedPubMedCentralCrossRef
18.
go back to reference Okafor II, Ugwu EO, Obi SN. Disrespect and abuse during facility-based childbirth in a low-income country. Int J Gynecol Obstet. 2015;128:110–3.CrossRef Okafor II, Ugwu EO, Obi SN. Disrespect and abuse during facility-based childbirth in a low-income country. Int J Gynecol Obstet. 2015;128:110–3.CrossRef
19.
go back to reference Rosen HE, Lynam PF, Carr C, et al. Direct observation of respectful maternity care in five countries : a cross-sectional study of health facilities in East and Southern Africa. BMC Pregnancy Childbirth. 2015;15:1–11.CrossRef Rosen HE, Lynam PF, Carr C, et al. Direct observation of respectful maternity care in five countries : a cross-sectional study of health facilities in East and Southern Africa. BMC Pregnancy Childbirth. 2015;15:1–11.CrossRef
20.
go back to reference Bohren MA, Vogel JP, Tunçalp Ö, et al. “By slapping their laps, the patient will know that you truly care for her”: A qualitative study on social norms and acceptability of the mistreatment of women during childbirth in Abuja, Nigeria. SSM - Popul Heal. 2016;2:640–55.CrossRef Bohren MA, Vogel JP, Tunçalp Ö, et al. “By slapping their laps, the patient will know that you truly care for her”: A qualitative study on social norms and acceptability of the mistreatment of women during childbirth in Abuja, Nigeria. SSM - Popul Heal. 2016;2:640–55.CrossRef
21.
go back to reference Bohren MA, Vogel JP, Tunçalp Ö, et al. Mistreatment of women during childbirth in Abuja , Nigeria : a qualitative study on perceptions and experiences of women and healthcare providers. Reprod Health. 2017;14:9.PubMedPubMedCentralCrossRef Bohren MA, Vogel JP, Tunçalp Ö, et al. Mistreatment of women during childbirth in Abuja , Nigeria : a qualitative study on perceptions and experiences of women and healthcare providers. Reprod Health. 2017;14:9.PubMedPubMedCentralCrossRef
22.
go back to reference Balde MD, Diallo BA, Bangoura A, et al. Perceptions and experiences of the mistreatment of women during childbirth in health facilities in Guinea : a qualitative study with women and service providers. Reprod Health. 2017;14:3.PubMedPubMedCentralCrossRef Balde MD, Diallo BA, Bangoura A, et al. Perceptions and experiences of the mistreatment of women during childbirth in health facilities in Guinea : a qualitative study with women and service providers. Reprod Health. 2017;14:3.PubMedPubMedCentralCrossRef
23.
go back to reference Asefa A, Bekele D. Status of respectful and non-abusive care during facility-based childbirth in a hospital and health centers in Addis Ababa, Ethiopia. Reprod Health. 2015;12:33.PubMedPubMedCentralCrossRef Asefa A, Bekele D. Status of respectful and non-abusive care during facility-based childbirth in a hospital and health centers in Addis Ababa, Ethiopia. Reprod Health. 2015;12:33.PubMedPubMedCentralCrossRef
24.
go back to reference Orpin J, Puthussery S, Davidson R, et al. Women’s experiences of disrespect and abuse in maternity care facilities in Benue State, Nigeria. BMC Pregnancy Childbirth. 2018;18:213.PubMedPubMedCentralCrossRef Orpin J, Puthussery S, Davidson R, et al. Women’s experiences of disrespect and abuse in maternity care facilities in Benue State, Nigeria. BMC Pregnancy Childbirth. 2018;18:213.PubMedPubMedCentralCrossRef
25.
go back to reference Moyer CA, Rominski S, Nakua EK, et al. Exposure to disrespectful patient care during training: Data from midwifery students at 15 midwifery schools in Ghana. Midwifery. 2016;41:39–44.PubMedCrossRef Moyer CA, Rominski S, Nakua EK, et al. Exposure to disrespectful patient care during training: Data from midwifery students at 15 midwifery schools in Ghana. Midwifery. 2016;41:39–44.PubMedCrossRef
26.
go back to reference Moyer CA, Adongo PB, Aborigo RA, et al. ‘ They treat you like you are not a human being ’ : Maltreatment during labour and delivery in rural northern Ghana. Midwifery. 2014;30:262–8.PubMedCrossRef Moyer CA, Adongo PB, Aborigo RA, et al. ‘ They treat you like you are not a human being ’ : Maltreatment during labour and delivery in rural northern Ghana. Midwifery. 2014;30:262–8.PubMedCrossRef
27.
go back to reference Rominski SD, Lori J, Nakua E, et al. When the baby remains there for a long time, it is going to die so you have to hit her small for the baby to come out: Justification of disrespectful and abusive care during childbirth among midwifery students in Ghana. Health Policy Plan. 2017;32:215–24.PubMed Rominski SD, Lori J, Nakua E, et al. When the baby remains there for a long time, it is going to die so you have to hit her small for the baby to come out: Justification of disrespectful and abusive care during childbirth among midwifery students in Ghana. Health Policy Plan. 2017;32:215–24.PubMed
28.
go back to reference Denscombe M. The good research guide for small scale social research projects. 4th ed. London: Open University Press; 2010. Denscombe M. The good research guide for small scale social research projects. 4th ed. London: Open University Press; 2010.
29.
go back to reference Nwaze I. A practical guide to research in the field of health and biostatistics. Abakaliki: Guzan publishers; 2002. Nwaze I. A practical guide to research in the field of health and biostatistics. Abakaliki: Guzan publishers; 2002.
30.
go back to reference StataCorp. Stata statistical software: Release 12. StataCorp. Stata statistical software: Release 12.
31.
go back to reference Uzochukwu BSC, Onwujekwe OE. Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: A case study of four local government areas operating the Bamako initiative programme in south-east Nigeria. Int J Equity Health. 2004;3:1–10.CrossRef Uzochukwu BSC, Onwujekwe OE. Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: A case study of four local government areas operating the Bamako initiative programme in south-east Nigeria. Int J Equity Health. 2004;3:1–10.CrossRef
32.
go back to reference IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.
34.
go back to reference Sheferaw ED, Bazant E, Gibson H, et al. Respectful maternity care in Ethiopian public health facilities. Reprod Health. 2017;14:1–12.CrossRef Sheferaw ED, Bazant E, Gibson H, et al. Respectful maternity care in Ethiopian public health facilities. Reprod Health. 2017;14:1–12.CrossRef
35.
go back to reference Kassa ZY, Tsegaye B, Abeje A. Disrespect and abuse of women during the process of childbirth at health facilities in sub-Saharan Africa : a systematic review and. BMC Int Health Hum Rights. 2020;20:23.PubMedPubMedCentralCrossRef Kassa ZY, Tsegaye B, Abeje A. Disrespect and abuse of women during the process of childbirth at health facilities in sub-Saharan Africa : a systematic review and. BMC Int Health Hum Rights. 2020;20:23.PubMedPubMedCentralCrossRef
36.
go back to reference Kassa ZY, Husen S. Disrespectful and abusive behavior during childbirth and maternity care in Ethiopia : a systematic review and meta - analysis. BMC Res Notes. 2019;12:83.PubMedPubMedCentralCrossRef Kassa ZY, Husen S. Disrespectful and abusive behavior during childbirth and maternity care in Ethiopia : a systematic review and meta - analysis. BMC Res Notes. 2019;12:83.PubMedPubMedCentralCrossRef
37.
go back to reference Bhattacharyya S, Srivastava A, Avan BI. Delivery should happen soon and my pain will be reduced: understanding women’s perception of good delivery care in India. Glob Health Action. 2013;6:e22635.CrossRef Bhattacharyya S, Srivastava A, Avan BI. Delivery should happen soon and my pain will be reduced: understanding women’s perception of good delivery care in India. Glob Health Action. 2013;6:e22635.CrossRef
38.
go back to reference Bohren M, Berger B, Munthe-Kaas H, et al. Perceptions and experiences of labour companionship: a qualitative evidence synthesis. Cochrane Database Syst Rev. 2019;3:CD012449.PubMed Bohren M, Berger B, Munthe-Kaas H, et al. Perceptions and experiences of labour companionship: a qualitative evidence synthesis. Cochrane Database Syst Rev. 2019;3:CD012449.PubMed
39.
go back to reference Vogel JP, Bohren MA, Tunçalp O, et al. Promoting respect and preventing mistreatment during childbirth. BJOG. 2016;123:671–4.PubMedCrossRef Vogel JP, Bohren MA, Tunçalp O, et al. Promoting respect and preventing mistreatment during childbirth. BJOG. 2016;123:671–4.PubMedCrossRef
40.
go back to reference Jungari S, Sharma B, Wagh D. Beyond Maternal Mortality : A Systematic Review of Evidences on Mistreatment and Disrespect During Childbirth in Health Facilities in India. Trauma Violence Abuse. 2019;XX:1–13. Jungari S, Sharma B, Wagh D. Beyond Maternal Mortality : A Systematic Review of Evidences on Mistreatment and Disrespect During Childbirth in Health Facilities in India. Trauma Violence Abuse. 2019;XX:1–13.
41.
go back to reference Amroussia N, Hernandez A, Vives-cases C, et al. “ Is the doctor God to punish me ?! ” An intersectional examination of disrespectful and abusive care during childbirth against single mothers in Tunisia. Reprod Health. 2017;14:32.PubMedPubMedCentralCrossRef Amroussia N, Hernandez A, Vives-cases C, et al. “ Is the doctor God to punish me ?! ” An intersectional examination of disrespectful and abusive care during childbirth against single mothers in Tunisia. Reprod Health. 2017;14:32.PubMedPubMedCentralCrossRef
42.
go back to reference Sadler M, Santos MJ, Ruiz-Berdún D, et al. Moving beyond disrespect and abuse: addressing the structural dimensions of obstetric violence. Reprod Health Matters. 2016;24:47–55.PubMedCrossRef Sadler M, Santos MJ, Ruiz-Berdún D, et al. Moving beyond disrespect and abuse: addressing the structural dimensions of obstetric violence. Reprod Health Matters. 2016;24:47–55.PubMedCrossRef
43.
go back to reference Warren N, Beebe M, Chase RP, et al. N è g è n è g è n : Sweet talk , disrespect , and abuse among rural auxiliary midwives in Mali. Midwifery. 2015;31:1073–80.PubMedCrossRef Warren N, Beebe M, Chase RP, et al. N è g è n è g è n : Sweet talk , disrespect , and abuse among rural auxiliary midwives in Mali. Midwifery. 2015;31:1073–80.PubMedCrossRef
44.
go back to reference Sudhinaraset M, Treleaven E, Melo J, et al. Women ’ s status and experiences of mistreatment during childbirth in Uttar Pradesh : a mixed methods study using cultural health capital theory. BMC Pregnancy Childbirth; 26. Epub ahead of print 2016. https://doi.org/10.1186/s12884-016-1124-4. Sudhinaraset M, Treleaven E, Melo J, et al. Women ’ s status and experiences of mistreatment during childbirth in Uttar Pradesh : a mixed methods study using cultural health capital theory. BMC Pregnancy Childbirth; 26. Epub ahead of print 2016. https://​doi.​org/​10.​1186/​s12884-016-1124-4.
45.
go back to reference Sando D, Abuya T, Asefa A, et al. Methods used in prevalence studies of disrespect and abuse during facility based childbirth: Lessons learned. Reprod Health. 2017;14:127.PubMedPubMedCentralCrossRef Sando D, Abuya T, Asefa A, et al. Methods used in prevalence studies of disrespect and abuse during facility based childbirth: Lessons learned. Reprod Health. 2017;14:127.PubMedPubMedCentralCrossRef
46.
go back to reference Azhar Z, Oyebode O, Masud H. Disrespect and abuse during childbirth in district Gujrat, Pakistan: A quest for respectful maternity care. Ann Glob Heal. 2017;83:108.CrossRef Azhar Z, Oyebode O, Masud H. Disrespect and abuse during childbirth in district Gujrat, Pakistan: A quest for respectful maternity care. Ann Glob Heal. 2017;83:108.CrossRef
47.
go back to reference Iloh G, Ofoedu J, Njoku P, et al. Satisfaction with Quality of Care Received by Patients without National Health Insurance Attending a Primary Care Clinic in a Resource-Poor Environment of a Tertiary Hospital in. Ann Med Heal Sci Res. 2013;3:31–7.CrossRef Iloh G, Ofoedu J, Njoku P, et al. Satisfaction with Quality of Care Received by Patients without National Health Insurance Attending a Primary Care Clinic in a Resource-Poor Environment of a Tertiary Hospital in. Ann Med Heal Sci Res. 2013;3:31–7.CrossRef
48.
go back to reference Okonofua F, Ogu R, Agholor K, et al. Qualitative assessment of women ’ s satisfaction with maternal health care in referral hospitals in Nigeria. Reprod Health. 2017;14:44.PubMedPubMedCentralCrossRef Okonofua F, Ogu R, Agholor K, et al. Qualitative assessment of women ’ s satisfaction with maternal health care in referral hospitals in Nigeria. Reprod Health. 2017;14:44.PubMedPubMedCentralCrossRef
49.
go back to reference Ukke GG, Gurara MK, Boynito WG. Disrespect and abuse of women during childbirth in public health facilities in Arba Minch town, South Ethiopia – a cross-sectional study. PLoS One. 2019;14:e0205545.PubMedPubMedCentralCrossRef Ukke GG, Gurara MK, Boynito WG. Disrespect and abuse of women during childbirth in public health facilities in Arba Minch town, South Ethiopia – a cross-sectional study. PLoS One. 2019;14:e0205545.PubMedPubMedCentralCrossRef
51.
go back to reference Kruk ME, Kujawski S, Mbaruku G, et al. Disrespectful and abusive treatment during facility delivery in Tanzania : a facility and community survey. Health Policy Plan. 2014;33:1–8. Kruk ME, Kujawski S, Mbaruku G, et al. Disrespectful and abusive treatment during facility delivery in Tanzania : a facility and community survey. Health Policy Plan. 2014;33:1–8.
52.
go back to reference Betron ML, Mcclair TL, Currie S, et al. Expanding the agenda for addressing mistreatment in maternity care : a mapping review and gender analysis. Reprod Health. 2018;15:143.PubMedPubMedCentralCrossRef Betron ML, Mcclair TL, Currie S, et al. Expanding the agenda for addressing mistreatment in maternity care : a mapping review and gender analysis. Reprod Health. 2018;15:143.PubMedPubMedCentralCrossRef
53.
Metadata
Title
Does disrespect and abuse during childbirth differ between public and private hospitals in Southeast Nigeria
Authors
Ijeoma Nkem Okedo-Alex
Ifeyinwa Chizoba Akamike
Irene Ifeyinwa Eze
Chika Nwamma Onwasigwe
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Care
Published in
BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-021-04298-z

Other articles of this Issue 1/2021

BMC Pregnancy and Childbirth 1/2021 Go to the issue