Table 1 GVtM items that align with WHO [63] typology of mistreatment
Bohren et al. – Third-Order Themes | Bohren et al. – Second -Order Themes | GVtM – US items and scales |
|---|---|---|
Physical abuse | Use of force | “You experienced physical abuse (including aggressive physical contact, inappropriate sexual conduct, a refusal to provide anesthesia for an episiotomy, etc.)” |
Physical restraint | ||
Sexual abuse | Sexual abuse | |
Verbal abuse | Harsh language | “Health care providers (doctors, midwives, or nurses) shouted at or scolded you” |
Threats and blaming | “Health care providers threatened to withhold treatment or to force you to accept treatment you did not want” | |
“Health care providers threatened you in any other way” | ||
Stigma and discrimination | Discrimination based on socio-demographic characteristics | Mothers on Respect (MOR) Index (14 items)a |
• Adapted 17-item Perceptions of Racism Scale | ||
• Four items that assess perceived discrimination from care providers or other disrespectful care provider behaviours, e.g. During my pregnancy I held back from asking questions or discussing my concerns because I felt discriminated against; During my pregnancy I held back from asking questions or discussing my concerns because my care provider used language I could not understand. | ||
• One item asking women how often they have felt treated unfairly because of their race, heritage or ethnic group | ||
Failure to meet professional standards of care | Lack of informed consent and confidentiality | “Your private or personal information was shared without your consent” |
“Your physical privacy was violated (i.e., being uncovered or having people in the delivery room without your consent)” | ||
Physical examinations and procedures | “My doctor or midwife explained different options for care during my labour and birth.” | |
“My doctor or midwife asked me what I wanted to do before the following procedures were done: (episiotomy, continuous fetal monitoring, screening tests etc).” | ||
Neglect and abandonment | ||
“Health care providers ignored you, refused your requests for help, or failed to respond to requests for help in a reasonable amount of time.” | ||
Poor rapport between women and providers | Ineffective communication | Mother Autonomy in Decision Making scale (MADM) (7 items)b |
• Three items that ask women to rate the level of respect, dignity and privacy that their care provider showed during labour and/or birth | ||
Lack of supportive care | ||
• Five items about care that women declined, what they declined, why, how their care provider reacted and if anyone helped the woman maintain her wishes. | ||
Loss of autonomy | ||
Health system conditions and constraints | Lack of policies | Adapted Perceptions of Racism Scale included items assessing treatment in medical offices and hospital wards |
Facility culture |