The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review

Summary

Background Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon. Methods and Findings We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology. Conclusions This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools and inform future research, programs, and interventions.

Key Points

• 1The review includes findings from sixty-five studies across thirty-four countries
• 2Seven domains of mistreatment were identified, including physical and verbal abuse
• 3High heterogeneity in quantitative data prevented a meta-analysis
• 4The proposed typology aims to standardize definitions and improve measurement tools
• 5Respectful care during childbirth is essential to protect women's rights and promote better health outcomes.

Related articles

• Community Hygiene, and Sanitation Unit 1 Reviewer - Importance and Role of Water in Health and Disease + Hydrologic Cycle

  This document provides a comprehensive overview of the importance of water in health and disease, detailing its essential roles, properties, and the consequences of water contamination on health. It includes information on hydration, the hydrologic cycle, and practical community hygiene measures.

• Complete High-Yield Skeletal System Reviewer

  This document provides a comprehensive overview of the skeletal system, detailing the anatomy, functions, and pathology of bones, joints, and associated structures. It includes classifications, types of bones, healing processes, and mnemonic aids for memorization.

• FUNDAMENTALS OF NURSING

  This document provides an overview of nursing as defined by the International Council of Nurses, highlighting nursing's role in individual health, historical context in the Philippines, and the evolution of nursing education and practice.

• Evolution of Nursing: A Comprehensive Overview

  This document provides an in-depth exploration of nursing, covering its history, fundamental concepts, professional responsibilities, education, and the evolution of nursing theories and practices. It highlights the significance of nursing as both an art and a science, emphasizing the necessary skills, ethics, and educational pathways for aspiring nurses.

• Effects of Ionizing Radiation on Biological Systems

  This document explores the biological effects of ionizing radiation, detailing its impact on human health, various types of cancer, and the responses of different populations exposed to radiation. It includes discussions on dose-response relationships, the mechanisms of radiation interaction with cells, and the implications for public health.