Exploring women’s experiences during childbirth in health facilities during COVID-19 pandemic in occupied palestinian territory: a cross-sectional community survey

Abstract

Introduction This study aims to assess the prevalence of mistreatment during childbirth in the occupied Palestinian territory and to explore factors associated with mistreatment. Methods A cross-sectional study of women who gave birth in the West Bank and Gaza Strip health facilities. The survey was administered over the phone to women up to 8 weeks post-partum. Data collection took place between July 2020 and March 2021. Results A total of 745 women participated in the study, 36·25% were from the Gaza Strip and 63·75% from the West Bank. The prevalence of mistreatment was 18·8% in which women reported any verbal abuse, physical abuse, or stigma or discrimination during childbirth, with verbal abuse as the most common form of mistreatment reported. Physical abuse was more likely to be reported by women with no labour companion with them (OR: 3·11, 95%CI: 1·24 − 7·99). Verbal abuse was more likely to be reported by women with less than three live births (OR: 1·71, 95%CI: 1·06 − 2·76, women with no birth companion (OR: 2·72, 95%CI: 1·36 − 3·80) and more likely to be reported if curtains wre not used (OR: 2·55, 95%CI: 1·33 − 4·88). Women with less education were more likely to report long waiting times or delays in receiving services compared to women with higher education (OR: 1·40, 95%CI: 1·06 − 2·10). Conclusion For the first time using the World Health Organisation (WHO) tool in the Eastern Mediterranean region, the study findings, show the occurrence of mistreatment and identify areas to be strengthened to ensure that all women have a respectful childbirth experience within health facilities.

Prevalence and risk factors of obstetric violence in the Gaza strip: A retrospective study from a conflict setting

“…The recent study by Abu‐Rmeileh et al 8 explored the mistreatment of women during labor in five health facilities in Palestine, with 36% of participants from Gaza and the rest from the West Bank. The study reported that nearly 19% of women reported some form of violence or abuse, with women in Gaza reporting higher levels (23%) than women in the West Bank (16.4%).…”

“…One study has explored OV determinants in Palestine, 7 but there have been none to date exploring the experiences of women living in the Gaza Strip. A recent study explored mistreatment during delivery among Palestinian women but focused on the West Bank (four out of five included hospitals) 8 . The conditions in Gaza are reportedly more difficult than in the West Bank as Gaza faces additional restrictions on travel, a higher unemployment rate, and was the subject of at least four major military operations in the last 15 years.…”

“…A recent study explored mistreatment during delivery among Palestinian women but focused on the West Bank (four out of five included hospitals). 8 The conditions in Gaza are reportedly more difficult than in the West Bank as Gaza faces additional restrictions on travel, a higher unemployment rate, and was the subject of at least four major military operations in the last 15 years. These stresses, combined with socioeconomic challenges, could affect the health service delivery and women's perceptions of their care.…”

Comparing observed occurrence of mistreatment during childbirth with women’s self-report: a validation study in Ghana, Guinea and Nigeria

“…Differences in women’s recall and understanding of mistreatment between exit interviews and subsequent surveys may also have implications for validity metrics presented here 9 13. More recently, more evidence has been emerging using phones to conduct surveys to capture experience of care during the postnatal period 34 35. Most validation studies on quality of maternal and newborn care have used observation as a reference standard10–12 including a recent study on mistreatment measures 19.…”

The association between labor companionship and obstetric violence during childbirth in health facilities in five facilities in the occupied Palestinian territory

“…A Cochrane intervention review reported the significance of the presence of help for women during childbirth. Women with support were less likely to have a Caesarean section, less likely to report negative feelings about their childbirth care experience, labor was shorter, and there was a reduction in unpleasant birth experiences [ 7 , 8 ].This companion can be the woman's spouse, husband, friend, healthcare professional, or family member [ 9 , 10 ] According to the absence of a labor companion, women who did not have a labor partner were more likely to experience physical abuse, feel abandoned, and have poor communication [ 10 ].…”