Abstract
The disrespect and abuse (D&A) of women during childbirth is common and a great concern in midwifery-led obstetric units (MOUs) in South Africa. This paper used the seven chapters of the Respectful Maternity Care Charter as a framework to explore women’s experiences of care during childbirth and examine the occurrence of D&A during childbirth in MOUs. Five focus group interviews were conducted with postnatal women aged 18 to 45 years selected purposively from MOUs in Tshwane District in South Africa. The discussions were audio-recorded, transcribed, and analyzed using a thematic approach and NVivo11 computer software. D&A of women was common during labor and childbirth. Verbal abuse in the form of shouting, labeling, judging, and rude remarks was the common form of D&A. Some of the women were abandoned and neglected, which resulted in their giving birth without assistance. Furthermore, the midwives violated their rights and denied them care such as pain relief medication, birth companions during childbirth, and access to ambulance services. Midwives are at the center of the provision of maternity care in MOUs in South Africa. Therefore, there is a need to strengthen interventions to adopt and implement policies that promotes respectful, nonabusive care during childbirth in MOUs.
Highlights
The World Health Organization (WHO) identifies delivery in a health facility as an important strategy that can reduce maternal mortality, especially when the delivery is attended by skilled healthcare professionals [1,2]
With regard to staffing in the midwifery-led obstetric units (MOUs), every team consists of two to five midwives, depending on the staff available for that particular MOU, and each team is led by an advanced midwife, who is a specialist midwife registered with the South African Nursing Council (SANC) [33]
The sample consisted of 36 women who participated in five focus group discussions (FGDs)
Summary
The World Health Organization (WHO) identifies delivery in a health facility as an important strategy that can reduce maternal mortality, especially when the delivery is attended by skilled healthcare professionals [1,2]. Deliveries in facilities is the most important strategy to reduce the prevalence of maternal death, some factors in low-income settings such as cultural belief, distance and transportation to health facility, costs of services, religious beliefs, and tradition of using traditional birth attendants still prevent women from using health facilities during childbirth [3,4,5]. A negative experience during labor and childbirth damages the trust between the woman and healthcare providers and impacts on the decision regarding future delivery in a health facility [9,12,13,14]. Relevant factors include the quality of the care received, the experience of abuse and disrespect during childbirth, and the fear of maltreatment by the healthcare providers [9,15]
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