The impact of mistreatment during childbirth
Mistreatment during childbirth may have both direct and indirect impacts on the woman and her baby. For example, a WHO qualitative study in Nigeria found that women and healthcare providers justified slapping a woman while she was in labour if it was done to encourage the woman to push.
- The role of health systems
A complex range of systemic challenges at both the health facility and health system levels contribute to the mistreatment of women, including poor supervisory structures, insufficient staffing, inadequate supply chains, poor physical conditions, and power dynamics that systematically disempower women.
Health systems must be held accountable for the mistreatment of women during childbirth, and improvements are needed to effectively prevent and respond to these harmful practices. Health systems must have sufficient resources to provide quality, accessible maternal health care and clear policies on women’s rights. Health-care providers at all levels require support and training to ensure that women are treated with compassion and dignity.
- The way forward
There has been progress on understanding the different manifestations of mistreatment during childbirth in different contexts. Further research is needed, however, to understand how institutional structures and processes can be reorganized to provide better woman-centred care.
Structural dimensions may influence mistreatment during childbirth via historical biases, power inequalities, normalization of poor treatment and communication barriers. Understanding drivers, such as gender and social inequalities, and judgements about women’s sexuality, is critical to ensure that any interventions adequately account for societal context.
Preventing mistreatment during childbirth can only be achieved through inclusive and equitable processes that engage both women and healthcare providers. Possible strategies include:
• Redesigning labour wards to allow for privacy and labour companionship
• Providing skills-building exercises for effective communication and on the informed consent process for all procedures
• Teaching providers stress-coping mechanisms
• Ensuring that healthcare providers are empowered and supported through supervisory structures; that workloads are manageable; and that remuneration is adequate.