Perceptions and experiences of the mistreatment of women during childbirth in health facilities in Guinea: a qualitative study with women and service providers

Abstract

BackgroundEvery woman is entitled to respectful care during childbirth; so it is concerning to hear of informal reports of mistreatment during childbirth in Guinea. This study sought to explore the perceptions and experiences of mistreatment during childbirth, from the perspectives of women and service providers, and the analysis presents findings according to a typology of mistreatment during childbirth.MethodsThis study used qualitative methods (in-depth interviews (IDIs) and focus group discussions (FGDs)) and was conducted with four groups of participants: women of reproductive age, midwives, doctors, and administrators. The study took place in two sites in Guinea, an urban area (Mamou) and peri-urban (Pita). Data collection was conducted in two health facilities for providers and administrators, and in the health facility catchment area for women. Data were collected in local languages (Pular and Malinké), then transcribed and analyzed in French. We used a thematic analysis approach and coded transcripts manually.ResultsA total of 64 IDIs and eight FGDs were conducted and are included in this analysis, including 40 IDIs and eight FGDs with women of reproductive age, 5 IDIs with doctors, 13 IDIs with midwives, and 6 IDIs with administrators. Participants described their own personal experiences, experiences of women in their communities and perceptions regarding mistreatment during childbirth. Results were organized according to a typology of mistreatment during childbirth, and included instances of physical abuse, verbal abuse, abandonment and neglect. Women described being slapped by providers, yelled at for noncompliance with provider requests, giving birth on the floor and without skilled attendance in the health facility. Poor physical conditions of health facilities and health workforce constraints contributed to experiences of mistreatment.ConclusionsThese results are important because they demonstrate that the mistreatment of women during childbirth exists in Guinea and occurs in multiple forms. These data should be used by the Ministry of Health and other stakeholders to develop strategies to reduce and prevent the mistreatment of women during childbirth.

A qualitative study on acceptability of the mistreatment of women during childbirth in Myanmar

“…High patient-to-provider ratios, and insufficient salaries for providers for long hours, overtime, and additional task were reported in our study, and these conditions may exacerbate frustration and stress of providers and constrain the provision of quality care. These findings are similar to a study in Guinea where it was reported that mistreatment occurred because providers were poorly trained and overworked [18].…”

“…The study used a mixedmethods design to understand and measure the mistreatment of women during childbirth in Myanmar, Nigeria, Ghana and Guinea. In the first phase, formative qualitative research was conducted to understand women's and providers' experiences and acceptability of mistreatment during childbirth [16][17][18][19][20][21]. The formative findings and systematic review [15] were used to inform the development of two measurement tools in the second phase (direct observations of labor and childbirth) and a community-based survey with women during the postpartum period in the same settings [22,23].…”

Childbirth experiences related to obstetric violence in public health units in Quito, Ecuador

“…Negligent care (5), including lack of breastfeeding help and absence of a professional during delivery. Confidentiality and discrimination (6)…”

“…Many studies have revealed and acknowledged disrespectful, offensive, and even negligent treatment of women during childbirth in health units in various parts of the world. [1][2][3][4][5] Several of these studies refer to physical violence, psychologic violence, verbal abuse, procedures performed without consent or with limited information, lack of privacy, and other non-recommended maternal care procedures. 6 Despite this evidence, a consensus on the way forward has not been reached at an international level.…”

Healthcare providers’ perspectives on labor monitoring in Nigeria and Uganda: A qualitative study on challenges and opportunities

“…23 Some of the contextual barriers-such as lack of respect and teamwork between obstetricians and midwives, heavy workloads, and challenges in maintaining continuity of labor monitoring and care by midwives-have been reported by health professionals in both high-and low/middleresource settings. [27][28][29][30] Although some of the health systems challenges may not be amenable in the short term, these findings provide a clear understanding of the potential obstacles that any labor monitoring tool must overcome to function in a real-life setting.…”