Perceived disrespect and abuse among women delivering at a tertiary care center in Nepal

Abstract

BackgroundOf the children born every year in Nepal, 57.4% are delivered in health facilities. Disrespect and abuse of women during maternity care are problems that can significantly impact women’s willingness to seek out life-saving maternity care. However, evidence suggests ongoing disrespectful maternity care worldwide. This study aims to identify perceived disrespect and abuse during labor and delivery among postnatal women delivering at Bheri Hospital, Nepal.MethodsA cross sectional study was conducted among 445 purposively selected women admitted in postnatal ward of Bheri Hospital, Nepal from February to March 2020. Ethical approval was obtained from Nepal Health Research Council. Informed written consent was obtained from each participant and a face-to-face interview was conducted for data collection. A semi-structured questionnaire consisting of demographic information and a pre-validated Respectful Maternity Care (RMC) tool was used. The information was then checked, coded, and entered in SPSS for descriptive and inferential analysis.ResultsIn this study, the participants perceived very high friendly care, abuse-free care and discrimination-free care but moderate timely care only. Timely care was found to be significantly associated with age, ethnicity, occupation, monthly income, gravida, type of delivery, and complications. On multinomial regression, monthly income and type of delivery were the only factors found to be significant. Those mothers who had spontaneous vaginal delivery were 2.07 times more likely to have neutral RMC, and those who earn less than twenty thousand Nepalese rupees per month were likely to perceive high timely RMC.ConclusionThis study concludes that disrespectful or abusive maternal care is not perceived among women delivering at Bheri Hospital in terms of friendly care, abuse-free care and non- discriminatory care. However, timely care is less reported. Appropriate interventions to provide timely care to delivering women must be instituted.

Directly observed and reported respectful maternity care received during childbirth in public health facilities, Ibadan Metropolis, Nigeria

“…This raises the challenge of how to measure RMC [14]. Client or provider interviews are most often reported in the literature [15][16][17][18]. However, there have been calls recommending a mixed-method approach, including independent observations to measure RMC [13,19,20].…”

Midwifery and nursing students’ perceptions of respectful maternity care and witnessing of disrespect and abuse: A comparative study from Nepal and Jordan

“…A study in eastern Nepal revealed various forms of disrespect and abuse among women such as non-consented care, verbal and physical abuse, non-confidential care, and discriminatory care (Ghimire et al, 2021). Conversely, three studies from central and western parts of Nepal found high prevalence of RMC practices (Gurung et al, 2021;Munikar et al, 2021;Pathak & Ghimire, 2020). Two studies reported that although women received care that was friendly, abuse free, and non-discriminatory, they wanted more timely care (Munikar et al, 2021;Pathak & Ghimire, 2020).…”

“…Conversely, three studies from central and western parts of Nepal found high prevalence of RMC practices (Gurung et al, 2021;Munikar et al, 2021;Pathak & Ghimire, 2020). Two studies reported that although women received care that was friendly, abuse free, and non-discriminatory, they wanted more timely care (Munikar et al, 2021;Pathak & Ghimire, 2020).…”

Perceived experience of respectful maternity care among mothers attending a selected teaching hospital of Kaski district

“…4,5,6 This has hampered the use of maternal health care programs, resulting in a decline in their health and well-being. 7 Women are vulnerable in any way during pregnancy, labor, or…”