Disrespect and abuse during childbirth in Western Ethiopia: Should women continue to tolerate?

• Published in: PloS one 2019-06, Vol.14 (6), p.e0217126-e0217126
• Main Authors: Tekle Bobo, Firew, Kebebe Kasaye, Habtamu, Etana, Belachew, Woldie, Mirkuzie, Feyissa, Tesfaye Regassa
• Format: Article
• Language: English
• Subjects: Abuse; Adolescent; Adult; Childbirth & labor; Cross-Sectional Studies; Delivery (Childbirth); Demography; Detention; Ethiopia; Female; Health care; Health care facilities; Health care policy; Health care reform; Health facilities; Health Facilities - statistics & numerical data; Health services; Hospital facilities; Humans; Maternal & child health; Maternal child nursing; Maternal mortality; Medical care; Medicine and Health Sciences; Mortality; Organizational aspects; Parturition - psychology; People and Places; Physical Abuse - psychology; Pregnancy; Professional-Patient Relations; Public health; Quality management; Regression models; Reproductive health; Social aspects; Women; Women's Rights; Womens health; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0217126

Healthcare coverage in Ethiopia has improved dramatically in recent decades. However, facility-based delivery remains persistently low, while maternal mortality remains high. This paper presents the prevalence and associated factors of disrespect and abuse (D&A) during childbirth in public health facilities of western Oromia, Ethiopia. A facility-based cross-sectional study was conducted among 612 women from February 2017 to May 2017. Exit interview with the mothers were conducted upon discharge from the maternity ward. We measured D&A during childbirth using seven dimensions. Multivariable logistic regression model was used to assess the association between experience of D&A and client characteristics and institutional factors. Three quarters (74.8%) of women reported experiencing at least one form of D&A during their facility childbirth. The types of D&A experienced by the women were; physical abuse (37.1%), non-dignified care (34.6%), non-consented care (54.1%), non-confidential care (40.4%), neglect (25.2%), detention (2.9%), and discrimination (13.2%). Experiences of D&A were 1.6 times more likely to be reported by women delivering at hospitals than health centers (OR: 1.64, 95% CI: 1.01, 2.66). Women without a companion throughout their delivery were almost 10 times more likely than women who had a companion to encounter D&A (OR: 9.94, 95% CI: 5.72, 17.28). On the other hand, women with more than 1,368-birr (USD 57) monthly income were less likely to experience any type of D&A (OR: 0.36, 95% CI: .21, .65). Three in four women reported experiencing at least one form of D&A during labor and delivery. This demonstrates a real disconnect between what the health system intends to achieve and what is practiced and calls for fundamental solutions in terms of both improving quality of facility-based delivery and ensuring women's right to receive health care with dignity.