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Table 3 Themes and their composition- clinical observations of labour and childbirth at maternity facilities

From: An investigation into mistreatment of women during labour and childbirth in maternity care facilities in Uttar Pradesh, India: a mixed methods study

Categories Themes Composition
1. Over-treatment a) Extreme fundal pressure Occurs frequently and help often sought from others present
b) Routine episiotomy Occurs frequently and often conducted without any analgesia.
2. Under-treatment c) Deficiencies in Infection prevention by individual health workers Using dirty clothes to clean the perineal and vaginal areas, unhygienic care procedures, conducting unnecessary procedures without proper infection prevention measures and using unsterile gloves and equipment.
d) Unqualified birth attendants Chronic staff shortages mean that unqualified health workers are often involved providing maternity care services.
e) Health facility environmental hygiene Limited adherence to infection management protocols, no facilities for hand washing, no use of antiseptics, non-availability of protective gear, inadequate sterilisation of equipment’s, aprons or facemasks, no waste disposal systems and stray animals such as dogs and cows in premises.
3. Disrespect and abuse f) Physical violence and verbal abuse Health workers are often anxious and sometimes use physical violence and verbal abuse. Physical abuse ranged from slapping the pregnant woman, to hitting and pinching her thighs or restraining forcefully. Verbal abuse ranged from talking down to the pregnant woman, using foul language and threatening women with caesarean sections, if they did not stop shouting or crying.
g) Informal payments Frequent in public sector maternity facilities. These range from Rupees 200–2000, equivalent £2.4 to £24