abstract: 'Background: This paper responds to the global call to action for

  respectful maternity care (RMC) by examining whether and how gender

  inequalities and unequal power dynamics in the health system undermine

  quality of care or obstruct women''s capacities to exercise their rights

  as both users and providers of maternity care.

  Methods: We conducted a mapping review of peer-reviewed and gray

  literature to examine whether gender inequality is a determinant of

  mistreatment during childbirth. A search for peer-reviewed articles

  published between January 1995 and September 2017 in PubMed, Embase,

  SCOPUS, and Web of Science databases, supplemented by an appeal to

  experts in the field, yielded 127 unique articles. We reviewed these

  articles using a gender analysis framework that categorizes gender

  inequalities into four key domains: access to assets, beliefs and

  perceptions, practices and participation, and institutions, laws, and

  policies. A total of 37 articles referred to gender inequalities in the

  four domains and were included in the analysis.

  Results: The mapping indicates that there have been important advances

  in documenting mistreatment at the health facility, but less attention

  has been paid to addressing the associated structural gender

  inequalities. The limited evidence available shows that pregnant and

  laboring women lack information and financial assets, voice, and agency

  to exercise their rights to RMC. Women who defy traditional feminine

  stereotypes of chastity and serenity often experience mistreatment by

  providers as a result. At the same time, mistreatment of women inside

  and outside of the health facility is normalized and accepted, including

  by women themselves. As for health care providers, gender discrimination

  is manifested through degrading working conditions, lack of respect for

  their abilities, violence and harassment,, lack of mobility in the

  community, lack of voice within their work setting, and limited training

  opportunities and professionalization. All of these inequalities erode

  their ability to deliver high quality care.

  Conclusion: While the evidence base is limited, the literature clearly

  shows that gender inequality-for both clients and providers-contributes

  to mistreatment and abuse in maternity care. Researchers, advocates, and

  practitioners need to further investigate and build upon lessons from

  the broader gender equality, violence prevention, and rights-based

  health movements to expand the agenda on mistreatment in childbirth and

  develop effective interventions.'
affiliation: 'Betron, ML (Corresponding Author), USAIDs Maternal \& Child Survival
  Program Jhpiego, 1776 Massachusetts Ave NW, Washington, DC 20036 USA.

  Betron, Myra L.; Currie, Sheena; Banerjee, Joya, USAIDs Maternal \& Child Survival
  Program Jhpiego, 1776 Massachusetts Ave NW, Washington, DC 20036 USA.

  McClair, Tracy L., Jhpiego, 1776 Massachusetts Ave NW, Washington, DC 20036 USA.'
article-number: '143'
author: Betron, Myra L. and McClair, Tracy L. and Currie, Sheena and Banerjee, Joya
author-email: Myra.Betron@jhpiego.org
author_list:
- family: Betron
  given: Myra L.
- family: McClair
  given: Tracy L.
- family: Currie
  given: Sheena
- family: Banerjee
  given: Joya
da: '2023-09-28'
doi: 10.1186/s12978-018-0584-6
files: []
issn: 1742-4755
journal: REPRODUCTIVE HEALTH
keywords: 'Disrespect and abuse; Mistreatment; Gender; Maternal health; Quality of

  care; Respectful maternity care (RMC); Gender-based violence'
keywords-plus: 'HEALTH-CARE; CHILDBIRTH; ABUSE; DISRESPECT; WOMEN; CHALLENGES; VIOLENCE;

  INTERVENTIONS; EXPERIENCES; FRAMEWORK'
language: English
month: AUG 28
number-of-cited-references: '61'
orcid-numbers: 'Banerjee, Joya/0000-0002-9076-2011

  Betron, Myra/0000-0002-1307-2949

  McClair, Tracy/0000-0002-5045-7514'
papis_id: e5201a56889f5a615257810137040aec
ref: Betron2018expandingagenda
researcherid-numbers: 'Banerjee, Joya/C-7949-2015

  '
tags:
- review
times-cited: '46'
title: 'Expanding the agenda for addressing mistreatment in maternity care: a mapping
  review and gender analysis'
type: Review
unique-id: WOS:000443348900001
usage-count-last-180-days: '0'
usage-count-since-2013: '7'
volume: '15'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2018'