Table 1 Typology of the mistreatment of women during childbirth (Reprinted with permission from [19])
Third order | Second order | First order |
|---|---|---|
Physical abuse | Use of force | Women beaten, slapped, kicked, and pinched during delivery |
Physical restraint | Women physically restrained to the bed or gagged during delivery | |
Sexual abuse | Sexual abuse | Sexual abuse or rape |
Verbal abuse | Harsh language | Harsh or rude language |
Judgmental and accusatory comments | ||
Threats and blaming | Threats of withholding treatment or poor outcomes | |
Blaming for poor outcomes | ||
Stigma and discrimination | Discrimination based on sociodemographic characteristics | Discrimination based on ethnicity/race/religion |
Discrimination based on age | ||
Discrimination based on socioeconomic status | ||
Discrimination based on medical conditions | Discrimination based on HIV status | |
Failure to meet professional standards of care | Lack of informed consent and confidentiality | Lack of informed consent process |
Breaches of confidentiality | ||
Physical examinations and procedures | Painful vaginal exams | |
Refusal to provide pain relief | ||
Performance of unconsented surgical operations | ||
Neglect and abandonment | Neglect, abandonment and long delays | |
Skilled attendant absent at time of delivery | ||
Poor rapport between women and providers | Ineffective communication | Poor communication |
Dismissal of women’s concerns | ||
Language and interpretation issues | ||
Poor staff attitudes | ||
Lack of supportive care | Lack of supportive care from health workers | |
Denial or lack of birth companions | ||
Loss of autonomy | Women treated as passive participants during childbirth | |
Denial of food, fluids and mobility | ||
Lack of respect for women’s preferred birth positions | ||
Denial of safe traditional practices | ||
Objectification of women | ||
Detainment in facilities | ||
Health systems conditions and constraints | Lack of resources | Physical condition of facilities |
Staffing constraints | ||
Supply constraints | ||
Lack of privacy | ||
Lack of policies | Lack of redress | |
Facility culture | Bribery and extortion | |
Unclear fee structures | ||
Unreasonable requests of women by health workers |