Mistreatment of women during childbirth in Abuja, Nigeria: A qualitative study on perceptions and experiences of women and healthcare providers Prof. Suellen Miller

Meghan A. Bohren, Joshua P. Vogel, Özge Tunçalp, Bukola Fawole, Musibau A. Titiloye, Akinpelu Olanrewaju Olutayo, Modupe Ogunlade, Agnes A. Oyeniran, Olubunmi R. Osunsan, Loveth Metiboba, Hadiza A. Idris, Francis E. Alu, Olufemi T. Oladapo, A. Metin Gülmezoglu, Michelle J. Hindin

Research output: Contribution to journalArticle

Abstract

Background: Global efforts have increased facility-based childbirth, but substantial barriers remain in some settings. In Nigeria, women report that poor provider attitudes influence their use of maternal health services. Evidence also suggests that women in Nigeria may experience mistreatment during childbirth; however, there is limited understanding of how and why mistreatment this occurs. This study uses qualitative methods to explore women and providers' experiences and perceptions of mistreatment during childbirth in two health facilities and catchment areas in Abuja, Nigeria. Methods: In-depth interviews (IDIs) and focus group discussions (FGDs) were used with a purposive sample of women of reproductive age, midwives, doctors and facility administrators. Instruments were semi-structured discussion guides. Participants were asked about their experiences and perceptions of, and perceived factors influencing mistreatment during childbirth. Thematic analysis was used to synthesize findings into meaningful sub-themes, narrative text and illustrative quotations, which were interpreted within the context of this study and an existing typology of mistreatment during childbirth. Results: Women and providers reported experiencing or witnessing physical abuse including slapping, physical restraint to a delivery bed, and detainment in the hospital and verbal abuse, such as shouting and threatening women with physical abuse. Women sometimes overcame tremendous barriers to reach a hospital, only to give birth on the floor, unattended by a provider. Participants identified three main factors contributing to mistreatment: poor provider attitudes, women's behavior, and health systems constraints. Conclusions: Moving forward, findings from this study must be communicated to key stakeholders at the study facilities. Measurement tools to assess how often mistreatment occurs and in what manner must be developed for monitoring and evaluation. Any intervention to prevent mistreatment will need to be multifaceted, and implementers should consider lessons learned from related interventions, such as increasing audit and feedback including from women, promoting labor companionship and encouraging stress-coping training for providers.

Original languageEnglish (US)
Article number9
JournalReproductive Health
Volume14
Issue number1
DOIs
StatePublished - Jan 17 2017

Keywords

  • Abuse
  • Childbirth
  • Disrespect
  • Maternal health
  • Mistreatment
  • Nigeria
  • Obstetric delivery
  • Qualitative research
  • Quality of care

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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    Bohren, M. A., Vogel, J. P., Tunçalp, Ö., Fawole, B., Titiloye, M. A., Olutayo, A. O., Ogunlade, M., Oyeniran, A. A., Osunsan, O. R., Metiboba, L., Idris, H. A., Alu, F. E., Oladapo, O. T., Gülmezoglu, A. M., & Hindin, M. J. (2017). Mistreatment of women during childbirth in Abuja, Nigeria: A qualitative study on perceptions and experiences of women and healthcare providers Prof. Suellen Miller. Reproductive Health, 14(1), [9]. https://doi.org/10.1186/s12978-016-0265-2