2023-09-28 14:46:10 +00:00
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abstract: 'Background Women across the world are mistreated during childbirth. We
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aimed to develop and implement evidence-informed, validated tools to
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measure mistreatment during childbirth, and report results from a
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cross-sectional study in four low-income and middle-income countries.
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Methods We prospectively recruited women aged at least 15 years in
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twelve health facilities (three per country) in Ghana, Guinea, Myanmar,
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and Nigeria between Sept 19, 2016, and Jan 18, 2018. Continuous
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observations of labour and childbirth were done from admission up to 2 h
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post partum. Surveys were administered by interviewers in the community
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to women up to 8 weeks post partum. Labour observations were not done in
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Myanmar. Data were collected on sociodemographics, obstetric history,
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and experiences of mistreatment.
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Findings 2016 labour observations and 2672 surveys were done. 838
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(41.6\%) of 2016 observed women and 945 (35.4\%) of 2672 surveyed women
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experienced physical or verbal abuse, or stigma or discrimination.
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Physical and verbal abuse peaked 30 min before birth until 15 min after
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birth (observation). Many women did not consent for episiotomy
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(observation: 190 {[}75.1\%] of 253; survey: 295 {[}56.1\%] of 526) or
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caesarean section (observation: 35 {[}13.4\%] of 261; survey: 52
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{[}10.8\%] of 483), despite receiving these procedures. 133 (5.0\%) of
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2672 women or their babies were detained in the facility because they
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were unable to pay the bill (survey). Younger age (15-19 years) and lack
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of education were the primary determinants of mistreatment (survey). For
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example, younger women with no education (odds ratio {[}OR] 3.6, 95\% CI
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1 .6-8.0) and younger women with some education (OR 1.6, 1.1-2.3) were
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more likely to experience verbal abuse, compared with older women (>= 30
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years), adjusting for marital status and parity.
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Interpretation More than a third of women experienced mistreatment and
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were particularly vulnerable around the time of birth. Women who were
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younger and less educated were most at risk, suggesting inequalities in
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how women are treated during childbirth. Understanding drivers and
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structural dimensions of mistreatment, including gender and social
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inequalities, is essential to ensure that interventions adequately
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account for the broader context. Copyright (C) 2019 This is an Open
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Access article published under the CC BY 3.0 IGO license which permits
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unrestricted use, distribution, and reproduction in any medium, provided
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the original work is properly cited.'
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affiliation: 'Bohren, MA (Corresponding Author), Univ Melbourne, Melbourne Sch Populat
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\& Global Hlth, Ctr Hlth Equ, Gender \& Womens Hlth Unit, Carlton, Vic 3053, Australia.
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Bohren, Meghan A., Univ Melbourne, Melbourne Sch Populat \& Global Hlth, Ctr Hlth
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Equ, Gender \& Womens Hlth Unit, Carlton, Vic 3053, Australia.
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Bohren, Meghan A.; Mehrtash, Hedieh; Thwin, Soe Soe; Landoulsi, Sihem; Gulmezoglu,
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A. Metin; Tuncalp, Ozge, WHO, UNDP UNFPA UNICEF WHO World Bank Special Programm,
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Dept Reprod Hlth \& Res, Geneva, Switzerland.
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Fawole, Bukola, Univ Ibadan, Dept Obstet \& Gynaecol, Natl Inst Maternal \& Child
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Hlth, Coll Med, Ibadan, Nigeria.
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Maung, Thae Maung; Mon, Nwe Oo, Dept Med Res, Yangon, Myanmar.
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Balde, Mamadou Dioulde; Diallo, Boubacar Alpha; Soumah, Anne-Marie; Sall, Alpha
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Oumar, Cellule Rech Sante Reprod Guinee CERREGUI, Conakry, Guinea.
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Maya, Ernest, Univ Ghana, Sch Publ Hlth, Dept Populat Family \& Reprod Hlth, Legon,
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Ghana.
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Aderoba, Adeniyi K., Mother \& Child Hosp, Dept Obstet \& Gynaecol, Akure, Ondo
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State, Nigeria.
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Vogel, Joshua P., Burnet Inst, Maternal \& Child Hlth Program, Melbourne, Vic, Australia.
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Irinyenikan, Theresa Azonima, Univ Med Sci Ondo, Fac Clin Sci, Dept Obstet \& Gynaecol,
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Ondo, Ondo State, Nigeria.
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Irinyenikan, Theresa Azonima, Univ Med Sci, Teaching Hosp, Akure, Ondo State, Nigeria.
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Adeyanju, A. Olusoji, Adeoyo Matern Teaching Hosp, Ibadan, Oyo State, Nigeria.
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Adu-Bonsaffoh, Kwame, Univ Ghana, Sch Med \& Dent, Dept Obstet \& Gynaecol, Accra,
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Ghana.
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Guure, Chris, Univ Ghana, Sch Publ Hlth, Dept Biostat, Legon, Ghana.
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Adanu, Richard, Univ Ghana, Sch Publ Hlth, Legon, Ghana.'
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author: Bohren, Meghan A. and Mehrtash, Hedieh and Fawole, Bukola and Maung, Thae
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Maung and Balde, Mamadou Dioulde and Maya, Ernest and Thwin, Soe Soe and Aderoba,
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Adeniyi K. and Vogel, Joshua P. and Irinyenikan, Theresa Azonima and Adeyanju, A.
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Olusoji and Mon, Nwe Oo and Adu-Bonsaffoh, Kwame and Landoulsi, Sihem and Guure,
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Chris and Adanu, Richard and Diallo, Boubacar Alpha and Gulmezoglu, A. Metin and
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Soumah, Anne-Marie and Sall, Alpha Oumar and Tuncalp, Ozge
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author-email: meghan.bohren@unimelb.edu.au
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author_list:
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- family: Bohren
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given: Meghan A.
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- family: Mehrtash
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given: Hedieh
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- family: Fawole
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given: Bukola
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- family: Maung
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given: Thae Maung
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- family: Balde
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given: Mamadou Dioulde
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- family: Maya
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given: Ernest
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- family: Thwin
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given: Soe Soe
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- family: Aderoba
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given: Adeniyi K.
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- family: Vogel
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given: Joshua P.
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- family: Irinyenikan
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given: Theresa Azonima
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- family: Adeyanju
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given: A. Olusoji
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- family: Mon
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given: Nwe Oo
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- family: Adu-Bonsaffoh
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given: Kwame
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- family: Landoulsi
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given: Sihem
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- family: Guure
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given: Chris
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- family: Adanu
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given: Richard
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- family: Diallo
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given: Boubacar Alpha
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- family: Gulmezoglu
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given: A. Metin
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- family: Soumah
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given: Anne-Marie
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- family: Sall
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given: Alpha Oumar
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- family: Tuncalp
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given: Ozge
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da: '2023-09-28'
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doi: 10.1016/S0140-6736(19)31992-0
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eissn: 1474-547X
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esi-highly-cited-paper: Y
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esi-hot-paper: N
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files: []
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issn: 0140-6736
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journal: LANCET
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keywords-plus: DISRESPECT; ABUSE; CARE; MISTREATMENT; QUALITY
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language: English
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month: NOV 9
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number: '10210'
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number-of-cited-references: '49'
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orcid-numbers: 'Maya, Ernest Tei/0000-0001-6050-6837
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Adu-Bonsaffoh, Kwame/0000-0002-3741-6646
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ADEROBA, Adeniyi Kolade/0000-0002-4333-9093
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Vogel, Joshua/0000-0002-3214-7096
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Maung, Thae Maung/0000-0002-1265-3813
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Tunçalp, Ӧzge/0000-0002-5370-682X
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Mehrtash, Hedieh/0000-0003-4991-616X
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Mon, Nwe Oo/0000-0001-5432-6880
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Bohren, Meghan/0000-0002-4179-4682'
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pages: 1750-1763
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papis_id: 073e13aaf56790ea6edfad7ec9d57cfd
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ref: Bohren2019howwomen
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researcherid-numbers: 'Maya, Ernest Tei/T-2576-2019
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Adu-Bonsaffoh, Kwame/AAH-5560-2020
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ADEROBA, Adeniyi Kolade/AAU-1426-2021
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Vogel, Joshua/K-7649-2019
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Maung, Thae Maung/S-2495-2018
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Tunçalp, Ӧzge/Y-2724-2018
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'
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times-cited: '203'
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title: 'How women are treated during facility-based childbirth in four countries:
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a cross-sectional study with labour observations and community-based surveys'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000496920300030
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usage-count-last-180-days: '3'
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usage-count-since-2013: '37'
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volume: '394'
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web-of-science-categories: Medicine, General \& Internal
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year: '2019'
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