Disrespect and abuse faced by women during facility based childbirth in District Chakwal

Abstract

BACKGROUND: Disrespectful and abusive practices by the providers during childbirth discourage many women to seek care at health facilities. This results in huge burden of maternal morbidities and mortalities. Despite severe impacts, such practices remain under the cover and are rarely reported in developing countries. OBJECTIVE: The study was carried out to estimate the prevalence and determinants of the disrespect and abuse (D & A) during child birth. METHODS: A cross sectional study was conducted in the tehsil Chakwal of District Chakwal. Data was collected using an interview based questionnaire from the women who had a live birth within last 24 hours (n=310). The Disrespect and Abuse scale was based on BOWSER AND HILL tool. Multiple logistic regression was used to assess the determinants of reported Disrespect and abuse. Chi-square was used to assess the determinants of Experienced Disrespect and abuse. RESULTS: Almost all the women experienced Disrespect and abuse (99.4%) during childbirth. However, only 26.2% reported it. Disrespect and abuse was more commonly reported for non-consented care. Disrespect and Abuse was reported by women living in Neutral household type (CI=1.256 – 4.529, OR = 2.385), further women living in any other household type reported Disrespect and Abuse (CI=0.104 – 34.118, OR = 1.886). Further, women attended by non-skilled birth attendants reported disrespect and abuse (CI= 1.716 – 34.137, OR= 7.653) and women attended by skilled birth attendants reported disrespect iv and abuse (CI= 1.776 – 7.298, OR= 3.600) , these are the main predictors of Reported Disrespect and Abuse. CONCLUSION: Disrespect and abuse during childbirth is highly prevalent in Pakistan. High Prevalence at facilities is may be a reason for underutilization of this sector for childbirth. To ensure respectful maternity Disrespect and abuse during Childbirth need to be eliminated. KEY WORDS: Maternal health, Disrespect and Abuse, Childbirth, Pakistan, Respectful Maternity Care.