Experiences and drivers of verbal abuse among women during labour and delivery in Ndola and Kitwe districts of Zambia

Abstract

Abstract: Verbal abuse during childbirth constitutes a violation of women’s human rights and indicates poor maternal health care. The aim of the study was to investigate experiences and drivers of verbal abuse among women in Ndola and Kitwe health facilities. The study adopted a cross-sectional survey. Qualitative and quantitative data using questionnaires and focus group interviews were employed. The study was done in the Ndola and Kitwe districts of Zambia. The target population were women attending postnatal services who had a live birth within 28 days of delivery. Twenty clinics were randomly selected and a total of 306 women were recruited using convenient sampling. Eleven percent of the study population experienced verbal abuse during intrapartum care. A 1-year increase in age reduced the odds of experiencing verbal abuse (Adjusted Odds Ratio [AOR] 0.89, 95% CI: 0.80–0.99). Women who consumed alcohol more frequently experienced verbal abuse than women who never consumed alcohol (adjusted odds ratio [AOR] 5.91, 99% CI 2.12–16.51), and women with bleached skin color more often experienced verbal abuse than women with natural skin tone (AOR = 3.95, 95% CI 1.13–13.83). Further, women with a medium skin tone were less likely (AOR = 0.17, 95% CI = 0.03–0.84) to experience verbal abuse. Other key drivers of verbal abuse include language barriers, laziness, vomiting, lack of seriousness, crying, lack of cooperation, and moving around during labour. We conclude that women experience various forms of verbal abuse. Therefore, there is a need to implement interventions that tackle the multiplicity of factors that drive verbal abuse at the individual, structural, and policy level. Further, there is a need to enhance training in respectful maternity care among service providers.