Disrespect and abuse during facility-based childbirth and its sociodemographic determinants - A barrier to healthcare utilization in rural population.

Abstract

The provider-driven disrespect and abuse (DA) of women during childbirth is a marker for quality of maternal care and violation of basic human rights. This study was done to assess prevalence and sociodemographic determinants of DA experienced during facility-based childbirth. This is a cross-sectional, community-based study done in six villages in the district of Aligarh, north India. In all, 305 women who underwent facility-based childbirth were interviewed by pretested and structured questionnaire at home between 4 and 6 weeks postpartum period. Descriptive statistics, Chi-square test, and bivariate regression analysis using SPSS 20.0 were used. A total of 257 (84.3%) of 305 women reported any form of DA. Nonconsented services (71.1%) and nonconfidential care (62.3%) were the most common types. Abandonment/neglect during childbirth was reported by 10.2% women, nondignified care by 9.2%, physical abuse by 5.9%, detention in the health facility by 3.3%, and discrimination by 3.9%. Women who had undergone vaginal birth [odds ratio (OR) 3.36; confidence interval (CI) 1.7-6.5], at public health facility (OR 2.65; CI 1.4-5.0), given care by providers other than doctors (OR 2.89; CI 1.5-5.5), who belonged to low socioeconomic status (OR 3.68; CI 1.4-9.7), and who did not decide place of delivery themselves (OR 4.49; CI 2.0-12.1) were more at risk of DA. Out of all females unwilling to attend facility in future, 93.8% reported experiencing DA. The association between any DA and decision to attend the facility in future was statistically significant. More than 8 of 10 women experienced any DA during facility-based childbirth. It can be a barrier to utilization of facility for childbirth. Preventing DA is important to improve quality of maternal care and institutional deliveries.