Table 2 D&A items and timing of observation during labor and delivery
Direct clinical observation item | Stage of labor |
|---|---|
Non dignified care | |
Did not respectfully greet pregnant woman | First |
Shouted, insulted or threatened the woman during labor or after | Applies to all observations |
Non consented care | |
Manual exploration of uterus after delivery when unindicated | Applies to all observations |
Used episiotomy (without indication) | Applies to all observations |
Did not ask woman (and support person) if she has any questions | First |
Did not ask client if there are any other problems the client is concerned about | First |
Did not explain procedures to woman (support person) before proceeding | First |
Did not inform the woman what will happen before conducting the vaginal examination | First |
Did not inform pregnant woman of findings | First |
Did not explain what will happen in labor to woman (support person) at least once | First |
Did not explains procedures to woman (support person) before proceeding | First |
Provider did not give at least one update on status and progress of labor | Third |
Non confidential care | |
Woman did not have audio and visual privacy | First |
Provider did not drape woman (one drape under buttocks, one over abdomen) | First |
Woman did not have her own bed | First |
Provider did not use curtains or other visual barriers to protect woman during exams, births, procedures | First |
Abandonment or denial of care | |
Provider did not encourage the woman to have a support person present during labor and delivery | First |
Provider did not encourage woman to consume fluids/food during labor at least once | First |
Provider did not encourage or assist woman to ambulate and assume different positions during labor at least once | First |
Provider did not ask woman which position she would like to deliver in | First |
Support person or companion for mother was not present at birth | Third |
If support person was not present at birth: Support person was restricted from being present | Third |
Woman requested some pain relief for her pain but was not given anything | Third |
Woman was not allowed to deliver in her preferred birthing position (if she had a preferred position) | Third |
Mother and newborn were not kept in same room after delivery (rooming-in) | Third |
Physical abuse | |
Provider slapped, hit or pinched the woman during labor or after | Applies to all observations |