BMJ 2015;351:h3656 doi: 10.1136/bmj.h3656 (Published 6 July 2015)
Page 1 of 1
Research News
RESEARCH NEWS Women worldwide are subjected to abuse in labour, study finds Anne Gulland London
Women across the world experience mistreatment in labour, including physical and verbal abuse, a lack of supportive care, neglect, discrimination and denial of autonomy, a systematic review has found.1 The study, published in PLoS Medicine, identified 65 studies undertaken in 34 countries detailing mistreatment by doctors, nurses, and other healthcare providers.
Being hit or slapped with the hand or an instrument was the most commonly reported physical abuse. Women also reported being pinched, particularly on the thighs, or being kicked. Verbal abuse was reported by women across all regions and income levels, with nurses and midwives being most commonly cited as the perpetrators. However, doctors and administrative staff were guilty too. Healthcare staff made inappropriate comments on women’s sexual activity and ridiculed or admonished them for failure to breast feed or for the absence of their partner during childbirth. Some women were threatened with withdrawal of treatment or even beatings because of their behaviour during childbirth.
Although some of the poor practice was clearly the result of failings of individual staff members, other mistreatment was due to systemic problems. Women and health workers reported a lack of privacy, particularly during vaginal and abdominal examinations where there was no curtain or screen. Other studies highlighted a lack of supplies such as drugs, gloves, and blood.
For personal use only: See rights and reprints http://www.bmj.com/permissions
Women also reported having to pay bribes to doctors and other healthcare staff and feeling unable to raise concerns about their treatment because of fears of repercussions.
Of the 65 studies just 12 included quantitative data, one of which looked at mistreatment in a teaching hospital in Nigeria. This found that 98% of women experienced at least one kind of mistreatment during labour. Another study, of care of women in Tanzania, found that up to 28.2% experienced mistreatment. A South African study found that 4.3% of women were slapped or struck, and a Brazilian study found that 9% were slapped or shouted at.
The authors said that the development of interventions to prevent mistreatment was a “critical next step.” They wrote, “A woman’s autonomy and dignity during childbirth must be respected and her health care providers should promote positive birth experiences through respectful dignified, supportive care, as well as by ensuring high-quality clinical care.” 1
Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. doi:10.1371/journal.pmed.1001847.
Cite this as: BMJ 2015;351:h3656 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Research News
RESEARCH NEWS Women worldwide are subjected to abuse in labour, study finds Anne Gulland London
Women across the world experience mistreatment in labour, including physical and verbal abuse, a lack of supportive care, neglect, discrimination and denial of autonomy, a systematic review has found.1 The study, published in PLoS Medicine, identified 65 studies undertaken in 34 countries detailing mistreatment by doctors, nurses, and other healthcare providers.
Being hit or slapped with the hand or an instrument was the most commonly reported physical abuse. Women also reported being pinched, particularly on the thighs, or being kicked. Verbal abuse was reported by women across all regions and income levels, with nurses and midwives being most commonly cited as the perpetrators. However, doctors and administrative staff were guilty too. Healthcare staff made inappropriate comments on women’s sexual activity and ridiculed or admonished them for failure to breast feed or for the absence of their partner during childbirth. Some women were threatened with withdrawal of treatment or even beatings because of their behaviour during childbirth.
Although some of the poor practice was clearly the result of failings of individual staff members, other mistreatment was due to systemic problems. Women and health workers reported a lack of privacy, particularly during vaginal and abdominal examinations where there was no curtain or screen. Other studies highlighted a lack of supplies such as drugs, gloves, and blood.
For personal use only: See rights and reprints http://www.bmj.com/permissions
Women also reported having to pay bribes to doctors and other healthcare staff and feeling unable to raise concerns about their treatment because of fears of repercussions.
Of the 65 studies just 12 included quantitative data, one of which looked at mistreatment in a teaching hospital in Nigeria. This found that 98% of women experienced at least one kind of mistreatment during labour. Another study, of care of women in Tanzania, found that up to 28.2% experienced mistreatment. A South African study found that 4.3% of women were slapped or struck, and a Brazilian study found that 9% were slapped or shouted at.
The authors said that the development of interventions to prevent mistreatment was a “critical next step.” They wrote, “A woman’s autonomy and dignity during childbirth must be respected and her health care providers should promote positive birth experiences through respectful dignified, supportive care, as well as by ensuring high-quality clinical care.” 1
Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. doi:10.1371/journal.pmed.1001847.
Cite this as: BMJ 2015;351:h3656 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
