Mistreatment of women during childbirth and its influencing factors in public maternity hospitals in Tehran, Iran: a multi-stakeholder qualitative study

Reproductive Health

Research

Abbas Rahimi Foroushani¹  Elham Shakibazadeh²  Marjan Mirzania²  Sedigheh Hantoushzadeh³  Abdoljavad Khajavi⁴  Meghan A. Bohren⁵  Farah Babaey⁶ 

[1] Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;Department of Obstetrics and Gynecology, School of Medicine, Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran;Department of Social Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran;Gender and Women’s Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia;Head of Department of Midwifery, Ministry of Health and Medical Education, Tehran, Iran;

关键词: Maternal health care;    Mistreatment;    Respectful maternity care;    Quality of care;    Maternity ward;    Labour and childbirth;   

DOI  :  10.1186/s12978-023-01620-0

 received in 2022-09-20, accepted in 2023-05-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMistreatment during labour and childbirth is a common experience for many women around the world. This study aimed to explore the manifestations of mistreatment and its influencing factors in public maternity hospitals in Tehran.MethodsA formative qualitative study was conducted using a phenomenological approach in five public hospitals between October 2021 and May 2022. Sixty in-depth face-to-face interviews were conducted with a purposive sample of women, maternity healthcare providers, and managers. Data were analyzed with content analysis using MAXQDA 18.ResultsMistreatment of women during labour and childbirth was manifested in four form: (1) physical abuse (fundal pressure); (2) verbal abuse (judgmental comments, harsh and rude language, and threats of poor outcomes); (3) failure to meet professional standards of care (painful vaginal exams, neglect and abandonment, and refusal to provide pain relief); and (4) poor rapport between women and providers (lack of supportive care and denial of mobility). Four themes were also identified as influencing factors: (1) individual-level factors (e.g., providers’ perception about women’s limited knowledge on childbirth process), (2) healthcare provider-level factors (e.g., provider stress and stressful working conditions); (3) hospital-level factors (e.g., staff shortages); and (4) national health system-level factors (e.g., lack of access to pain management during labour and childbirth).ConclusionsOur study showed that women experienced various forms of mistreatment during labour and childbirth. There were also multiple level drivers for mistreatment at individual, healthcare provider, hospital and health system levels. Addressing these factors requires urgent multifaceted interventions.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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