Abstract
BackgroundMistreatment of women in healthcare settings during childbirth has been gaining attention globally. Mistreatment during childbirth directly and indirectly affects health outcomes, patient satisfaction, and the likelihood of delivering in a facility currently or in the future. It is important that we study patients’ reports of mistreatment and abuse to develop a deeper understanding of how it is perpetrated, its consequences, and to identify potential points of intervention. Patients’ perception of the quality of care is dependent, not only on the content of care, but importantly, on women’s expectations of care.MethodsThis study uses rich, mixed-methods data to explore women’s characteristics and experiences of mistreatment during childbirth among slum-resident women in Uttar Pradesh, India. To understand the ways in which women’s social and cultural factors influence their expectations of care and consequently their perceptions of respectful care, we adopt a Cultural Health Capital (CHC) framework. The quantitative sample includes 392 women, and the qualitative sample includes 26 women.ResultsQuantitative results suggest high levels of mistreatment (over 57 % of women reported any form of mistreatment). Qualitative findings suggest that lack of cultural health capital disadvantages patients in their patient-provider relationships, and that women use resources to improve care they receive. Participants articulated how providers set expectations and norms regarding behaviors in facilities; patients with lower social standing may not always understand standard practices and are likely to suffer poor health outcomes as a result. Of importance, however, patients also blame themselves for their own lack of knowledge.ConclusionsLack of cultural health capital disadvantages women during delivery care in India. Providers set expectations and norms around behaviors during delivery, while women are often misinformed and may have low expectations of care.
Highlights
Mistreatment of women in healthcare settings during childbirth has been gaining attention globally
Maternal mortality remains a significant public health issue globally, and a growing literature suggests that mistreatment of women in healthcare settings must be addressed in order to improve mortality outcomes [1,2,3]
A study in Tanzania suggests that women who experience disrespectful or abusive care reported less satisfaction with their delivery, perceived quality of care for delivery, and were less likely to deliver in the same facility [8]
Summary
Mistreatment of women in healthcare settings during childbirth has been gaining attention globally. Mistreatment during childbirth directly and indirectly affects health outcomes, patient satisfaction, and the likelihood of delivering in a facility currently or in the future. Maternal mortality remains a significant public health issue globally, and a growing literature suggests that mistreatment of women in healthcare settings must be addressed in order to improve mortality outcomes [1,2,3]. Mistreatment directly and indirectly effects health outcomes, patient satisfaction, and the likelihood of delivering in a facility currently or in the future [5, 6]. A study in Tanzania suggests that women who experience disrespectful or abusive care reported less satisfaction with their delivery, perceived quality of care for delivery, and were less likely to deliver in the same facility [8]. Analyses suggest that were respectful care and availability of drugs/ equipment to improve, that the proportion of women preferring a facility delivery would increase from 43 to 88 % [5]
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