Table 2 Mapping typologies of disrespectful care for mothers and newborns, with references where available
“Third order themes” | “Second order” themes specific to newborns |
|---|---|
Physical abuse | Slapping infant or immersing in cold water for resuscitation [24] |
Suctioning without medical indication [25] | |
Unnecessary, painful medical procedures [26] | |
Non-gentle or unsafe handling or shaking of newborn [27] | |
Verbal abuse | Women blamed for poor neonatal outcomes, small infant, female newborn [2] |
Small, sick or disabled newborns seen as “defective” [8] | |
Stigma and discrimination | Discrimination against poor, illiterate, minority, patients [2] |
Some babies considered “too sick to save” [8] | |
Denial or threatened denial of postnatal care because home-born [9] | |
Discrimination against twins [29] | |
Discrimination against female infants [30] | |
Failure to meet professional standards of care | Unnecessary separation of mother/parent/caregiver and newborn [31] |
Not enough providers for mother and newborn [2] | |
Lack of/poor labour monitoring, lack of preparedness for delivery and to receive newborn [19] | |
No breastfeeding support [1] | |
Food restrictions or non-allowance of traditional foods for postpartum mothers [2] | |
Non-consented treatment of a newborn [31] | |
Fears of lack of privacy or confidentiality, especially related to HIV status of infant [20] | |
Neglect/abandonment [1] | |
No analgesic/palliative care options [34] | |
Crowded conditions, shared beds [2] | |
Early discharge from facility [15] | |
No translation or interpretation services [1] | |
Unnecessary medical procedures (e.g. blood draws, injections) [25, 26] | |
Poor rapport between patients and providers | Women blamed for poor neonatal outcomes, small infant, female newborn [2] |
Unnecessary separation of mother/parent/caregiver and newborn [31] | |
Non-consented treatment of newborn [31] | |
Lack of breastfeeding, thermal care or other postpartum support [15] | |
Health system conditions and constraints | Not enough providers for mother and newborn [2] |
Unavailable or insufficient equipment for newborn care [2] | |
Room cold or dirty (e.g. exposure to bacteria) [33] | |
Newborn left alone or unattended [1] | |
Added category: Legal accountability | No birth/death registration [35] |
Poor governance of health system/no legal recourse for malpractice [19] | |
Added category: Bereavement and posthumous care | No/inappropriate bereavement options offered [12] |
No options for autopsies/verbal autopsies [18] | |
Deleted category: Sexual abuse | No evidence for newborns |