Health Facilities For Childbirth Research Articles

Respectful maternity care during childbirth: Experiences and observation among mothers in a tertiary-care institute in Manipur

ABSTRACT Background: Respectful maternity care (RMC) refers to the humane and dignified treatment of a childbearing woman throughout her pregnancy, childbirth and immediate postpartum period. Disrespect and abuse of women during labour, childbirth and immediate postpartum period in health facilities is one of the reasons which deter them from further utilizing maternal healthcare services. The present study was thus undertaken to determine to what extent RMC practices are being followed in a health facility in Manipur. Materials and Methods: A cross-sectional study was conducted from May 2022 to August 2022 in a Health facility among women coming for institutional delivery along with direct observations of the labour room. The study tool comprises a semistructured questionnaire related to respectful maternity care which was adapted from the Person-Centered Maternity Care Scale, a validated instrument. The direct observation method was carried out using a checklist adapted from a standardized tool developed by the United States Agency for International Development (USAID). Descriptive statistics were generated and approval of the study was obtained from the Institutional Ethics Committee. Results: A total of 336 (99.1%) women reported at least one form of disrespect or abuse during childbirth. Maximum abuse (91.4%) was reported in the facility and environment domain. Direct observation done on 22 deliveries in the labour room found that 72.7% of the women experienced at least one form of disrespect and abuse. Two (9.1%) women were observed to face physical force or abusive behaviour. Conclusion: Almost all the women reported at least one form of disrespect or abuse during childbirth. There is a need to improve the health facilities and women need to be treated with dignity and respect as it is being violated according to the findings in many studies as with ours.

Respectful maternity care interventions to address women mistreatment in childbirth: What has been done?

IntroductionOver the last decade, there has been an increasing number of studies regarding experiences of mistreatment, disrespect and abuse (D&A) during facility-based childbirth. These negative experiences during labour have been proven to create a barrier for seeking both facility-based childbirth and postnatal health care, as well as increasing severe postpartum depression among the women who experienced them. This constitutes a serious violation of human rights. However, few studies have carried out specifically designed interventions to reduce these practices. The aim of this scoping review is to synthetise available evidence on this subject, and to identify initiatives that have succeeded in reducing the mistreatment, D&A that women suffer during childbirth in health facilities.MethodsA PubMed search of the published literature was conducted, and all original studies evaluating the efficacy of any type of intervention specifically designed to reduce these negative experiences and promote RMC were selected.ResultsTen articles were included in this review. Eight studies were conducted in Africa, one in Mexico, and the other in the U.S. Five carried out a before-and-after study, three used mixed-methods, one was a comparative study between birth centres, and another was a quasi-experimental study. The most common feature was the inclusion of some sort of RMC training for providers at the intervention centre, which led to the conclusion that this training resulted in an improvement in the care received by the women in childbirth. Other strategies explored by a small number of articles were open maternity days, clinical checklists, wall posters and constant user feedback.DiscussionThese results indicate that there are promising interventions to reduce D&A and promote RMC for women during childbirth in health facilities. RMC training for providers stands as the most proven strategy, and the results suggest that it improves the experiences of care received by women in labour.ConclusionThe specific types of training and the different initiatives that complement them should be evaluated through further scientific research, and health institutions should implement RMC interventions that apply these strategies to ensure human rights-based maternity care for women giving birth in health facilities around the world.

Reported respectful maternity care received during childbirth at health facilities: A cross sectional survey in Eastern province, Rwanda

BackgroundRespectful maternity care (RMC) fosters positive childbirth experiences and ensures safe motherhood. While past Rwandan studies on childbirth predominantly focused on negative experiences, our research delved into positive experiences. This study aimed to assess the RMC level experienced by women during childbirth in health facilities of Eastern Province of Rwanda. MethodologyWe conducted a cross-sectional survey on 610 mothers at their discharge across five public hospitals. We used a 15-items RMC questionnaire developed by White Ribbon Alliance, version of 2019. To manage the right-skewed data, we employed a median cut-off, categorizing experiences into binary outcome (low and high RMC score). We performed stepwise backward elimination logistic regression model to identify predictors of high RMC. FindingsThe majority (70.2%) reported experiencing RMC. The most acclaimed RMC items (over 90%) included allowance of food and fluid intake (98.5%), non-discrimination (96.2%), receipt of necessary services (96.1%), and privacy (91.3%). The chi-square analysis showed an association between reported high RMC and marital status (p-value = 0.006), occupation (p-value = 0.001), and mode of delivery (p-value = 0.001). Caesarean section delivery was associated with high RMC in multivariate logistic regression with a p-value of 0.001, the adjusted odds ratio was 2.11 with a CI [1.40–3.17]. ConclusionThe reported RMC items and care appreciated at high level should be sustained. Regardless of mode of delivery, all mothers should experience consistent, utmost respect throughout the childbirth and should receive RMC at maximum level.

Determinants of Family Empowerment in Utilizing Health Services in Kupang, Indonesia: A Cross-Sectional Study

Complications during pregnancy, childbirth, and postpartum are responsible for maternal deaths, however, childbirth in health facilities is far from the Strategic Plan target (88.9%). The majority of Timorese people still live with their parents, so care decisions depend on the parents/relatives. There is a tradition of "Se'i-tatobi), namely that mothers and babies will bathe in hot water and have a fire during the postpartum period. Apart from that, Timorese society is a patriarchal society where women do not have a significant position which can be seen from the weak position of women relative to men. Method. This research uses mixed method research, this research looks for the influence between variables, carried out with a cross-sectional research design. The research target population is families (mother-in-law, biological mother, or other relatives involved) who have pregnant women in the third trimester of pregnancy in Kupang Regency. The number of puskesmas in Kupang Regency is 26 puskesmas. The sample required is relatively large, the minimum required is up to 50 data samples for a predictor (independent) variable. It can select relationships because it uses a non-linear log transformation approach to predict odds so it uses a logistic regression analysis test. Result. Based on the data above, it shows that of the ten independent variables, there are 2 variables, namely parity and husband's job, which do not affect family empowerment, while the variables of mother's age, mother's education, husband's age, husband's education, place of birth of last child, helper, access, birth status are significant. influencing family empowerment. Conclusion Based on the data above, the mother's age, mother's education, husband's age, husband's education, place of birth of the last child, helper, and access also show family empowerment which significantly influences the family's ability to use it.

Rural-urban differences in distributions and determinants of facility delivery among women in Bangladesh

IntroductionThe utilization of facility delivery is crucial to achieve sustainable development goals by reducing maternal and neonatal deaths. This study aimed to compare the distributions and determinants of childbirth in health facilities in urban and rural regions of Bangladesh. MethodsCross-sectional data from the 2017‒2018 Bangladesh Demographic and Health Survey were analyzed. Multilevel logistic regression was applied. ResultsA total of 4 751 women were included in the analyses. Only 50% of childbirths took place in health facilities, 63.4% and 44.6% in urban and rural regions, respectively. Overall, the odds of the association between facility delivery and the studied factors were similar. Multiparous women had significantly lower odds of facility delivery in both rural (adjusted odds ratio [AOR] = 0.3, 95% confidence interval [CI]: 0.2 to 0.5) and urban (AOR = 0.2, 95% CI: 0.1 to 0.5) regions. In both regions, women with higher education levels, highly educated husbands, antenatal care (ANC), and higher wealth indexes had significantly higher odds of facility delivery. ConclusionSeveral common associated factors were identified. However, differences were observed regarding distributions of these factors. The differences in facility delivery utilization could result from lower ANC utilization, socioeconomic status, and transportation facilities in rural regions than urban regions; therefore, improving these conditions could increase facility delivery in these regions.

Disrespect and abuse during childbirth in East Hararghe Zone public health facilities, eastern Ethiopia: a cross-sectional study

BackgroundCompassionate and respectful maternity care during childbirth has been identified as a potential strategy to prevent and reduce maternal mortality and morbidity. Despite its importance, there is a paucity of information on the level of disrespect and abuse meted out to mothers in eastern Ethiopia. This study assesses the level of disrespect and abuse suffered by women during childbirth, and the associated factors, in public health facilities in the rural East Hararghe Zone in eastern Ethiopia.MethodsA cross-sectional study was conducted among 530 women who gave birth in 20 public health facilities in the East Hararghe Zone during the period between 1 April and 30 April 2020. Data were collected using a validated questionnaire. Bivariable and multivariable binary logistic regression analyses were employed to identify the factors associated with disrespect and abuse during childbirth. Adjusted odds ratio (AOR) (95% CI) was used to report this association, and statistical significance was set at P < 0.05.ResultsOverall, 77% (95% CI: 73%–81%) of women reported at least one type of disrespect and abuse during childbirth in the East Hararghe Zone public health facilities. In this study, factors such as households having an average monthly income of below 57.22 USD (AOR = 2.29, 95% CI: 1.41–3.71), mothers residing at more than 30 min away from a nearby health facility (AOR = 2.10, 95% CI: 1.30–3.39), those not receiving antenatal care (AOR = 4.29, 95% CI: 2.17–8.52), and those giving birth during nighttime (AOR = 2.16, 95% CI: 1.37–3.41) were associated with at least one type of disrespect and abuse during childbirth.ConclusionMore than three in every four women who gave birth in the East Hararghe Zone public health facilities were disrespected and abused during childbirth. Encouraging all pregnant women to pay attention to antenatal care visits and improving the quality of healthcare service during nighttime in all health facilities will be essential for preventing and reducing disrespect and abuse and its negative consequences.

Factors Influencing Delivery Achievement in Health Facilities in the Working Area of the Bungus Health Center 2020

Health efforts that can be given in reducing mortality such as normal childbirth care with a new paradigm. The purpose of the study was to determine the factors that influence the achievement of childbirth in health facilities in the Bungus Health Center work area in 2020. This type of research is analytical design using the Cross-sectional study approach. This study was conducted from January 2020 to December 2020 in the Bungus Health Center work area in 2020, with a population of 149 people, a research sample of 53 respondents, data collection techniques, namely primary data, sampling techniques, simple random sampling techniques. Data processing techniques with editing, coding, data entry, tabulating, cleaning. Data analysis with univariate analysis and bivariate analysis with Chi-Square test. This research was obtained by almost all respondents with good childbirth achievement with a percentage of 66%, as many as 52.8% of respondents with good education, 54.7% of respondents with good knowledge, 58.5% of respondents with good infrastructure, and 56.6% of respondents with the support of good health officers. Based on the results of data analysis, there is a relationship between education and childbirth achievement (p = 0.004), there is a relationship between knowledge and labor achievement (p = 0.011), there is a relationship between infrastructure and childbirth achievement (p = 0.018), and there is a relationship of health worker support with labor achievement (p = 0.031). It can be concluded that education, knowledge, infrastructure, support of health workers. The most ideal place for giving birth is a health facility with equipment and personnel who are ready to help if birth complications occur. At least in health facilities such as community health centers that are able to provide basic emergency obstetric and neonatal services. Keywords: Achievement of childbirth; health facilities; knowledge

Men's determinant factors on antenatal care involvement and childbirth place preference in Indonesia: An analysis of the 2012 Indonesia Demographic and Health Survey (IDHS).

This study aimed to describe the determinant factors of men's involvement in antenatal care and childbirth place preference in Indonesia. Secondary data from the 2012 Indonesia Demographic and Health Survey was used to identify factors determining men's presence during antenatal care and childbirth place preference. All factors were analyzed utilizing bivariate and multivariate logistic regression. Men living in urban areas, having a sufficient economy, having higher educational levels, and having more interaction with mass media were more likely present during the antenatal care of their wives. Men in Sulawesi and Maluku showed lower involvement in accompanying wives during antenatal care than those in Papua. In terms of delivery place preference, men in age 15-19 and 35-49 years, living in urban areas, having a more stable economy, reading newspapers or magazines as well as watching television at least once a week, and living in Java and Nusa Tenggara, were more likely having wife giving birth in healthcare facilities. Type of residence, economic situations, lower educational level, and fewer interactions with mass media and electronics are essential barriers to men's involvement in wives' antenatal care visits and childbirth place preference in Indonesia. Particular attention should be put to Sulawesi and Maluku to enforce the men and women as those islands underutilized antenatal care services and health facilities for childbirth.

The association between labor companionship and obstetric violence during childbirth in health facilities in five facilities in the occupied Palestinian territory

BackgroundStudies show that the presence of companionship during childbirth leads to positive outcomes for women. This study investigates the protective effect of having a labor companion on obstetric violence in the health facilities of the Occupied Palestinian Territory.MethodsA secondary analysis of a cross-sectional study of women who gave birth in five health centers in the occupied Palestinian territory up to 8 weeks following childbirth was performed. The presence of a labor companion was examined in relation to socioeconomic variables and physical abuse, verbal abuse or stigma or discrimination, failure to achieve professional standards, vaginal examinations, and pain relief.ResultsAccording to the findings, the total number of women with a labor partner or a birth companion present at any stage during the labor process was 92% in the West Bank, and 77.4% in the Gaza Strip. According to the timing of support, 23.5% of women had a labor companion present during labor, childbirth, and after childbirth whilst in the hospital. Women who did not have labor companions were more likely than women who did to report at least one sort of mistreatment, such as unconsented procedures. Women with a labor companion were less likely to report abuse (16%) compared to women without labor companion. In terms of informed permission for procedures, 75% of women who did not have a labor companion had unconsented episiotomy.ConclusionLabor companionship assists women by providing them with companions who are less likely to be mistreated during labor. Efforts should be made to best implement the presence of labor companions, including the duration of the labor companionship and women's preferences.

Status, Associated Factors, and Reasons for Bypassing the Childbirth Center among Postpartum Women in the Dire Dawa Administration, Ethiopia: a Mixed Study

Background: Childbirth in nearby health facilities is an important strategy to reduce complications for mothers and newborns, including death. Bypassing nearby birthing health facilities is common in developing countries. However, there is a lack of data in the study area on the extent and reasons for bypassing. Therefore, this study was aimed at assessing these gaps. Methods: A facility-based mixed study was conducted at the Dire Dawa administration, Ethiopia, from December 1–30, 2022. Simple random (quantitative) and purposive (qualitative) sampling techniques were used. Data were collected through interviews using structured (quantitative) and semi-structured (qualitative) questionnaires. Quantitative data were entered and cleaned by Epi DATA (Version 3.1) and analyzed using SPSS (Version 22). A P-value of 0.05 or less at multivariate with 95% confidence intervals was considered statistically significant. Qualitative data were thematically analyzed. Results: 635 participants (quantitative) and twelve for the qualitative analysis were included. The overall bypass was 30.9%. Higher age group (AOR = 2.34, 95% CI: 1.43–3.82), rural residence (AOR = 1.89, 95% CI: 1.11-3.22), no formal education (AOR = 2.26, 95% CI: 1.23–4.16), obstetric care needs during antenatal care (AOR = 2.37, 95% CI: 1.33–4.22), and health professionals’ behavior (AOR = 3.10, 95% CI: 1.99–4.78) were associated with a higher likelihood of bypassing. Conclusion: Bypassing childbirth health facilities was moderate. Perception, health professionals, and facility-related factors were the main identified themes in the qualitative results. Stakeholders recommended improving obstetrics services and researchers conducting additional research.

Dignified motherhood? Women experiences of abusive treatment and condemned care during childbirth in the health facilities of urban India

Background India has progressed in reducing maternal mortality in the last decade, indicating the impact of several health programs launched by the government. However, recent evidence indicates that the quality of care and healthcare providers’ behavior during delivery in health facilities is suboptimal in government health facilities. The current study aims to examine the prevalence of various mistreatment and disrespect practices during childbirth in health facilities, and further study explores the women’s experiences with a qualitative approach. Methods The study used a community-based cross-sectional design with a mixed-method approach. Both quantitative and qualitative data have been collected from the recently delivered mothers. Using a simple random sampling method recruited 260 recently delivered women from low-income communities in Pune city India. The qualitative data from 15 in-depth interviews were conducted with women who reported experiences of disrespect and mistreatment during childbirth. Results The quantitative result shows that 16.5% of respondents reported physical abuse, 11.9%. Abandonment of care, 35.9% non-consented care, more than half 67% reported condemned care, and 69% reported non-dignified care. Qualitative results also confirm the inhumane practices of healthcare providers during childbirth. Conclusions The study reveals that the non-dignified and disrespectful behaviour with physical abuse by the healthcare workers contributes to women’s higher mental and emotional instability, affecting the mother and child’s health.

UNDERSTANDING THE PHENOMENON OF LABOUR ROOM VIOLENCE AGAINST PREGNANT WOMEN: PERCEPTIONS AND PRACTICES OF HCP'S AND CHANGES AFTER RMC PRACTICES

Objectives: To understand the phenomenon of labour room violence against women and HCP's perceptions of behaviours constituting mistreatment in labour room, to study the factors responsible for mistreatment in labour rooms and to study the changes after training of RMC practices. Methods: This study analyses mixed-methods data obtained through systematic clinical observations and open-ended comments recorded by the observers to describe care and in -depth interview to capture HCPs perception of labour room violence. Findings: There are 7 major categories of disrespect and abuse that women encountered during childbirth in health facilities which are verbal abuse, non-consented clinical care, non-condential care (including denial of privacy), non-dignied care, discrimination based on specic patient attributes, abandonment or denial of care and detention in facilities.(1) According to the present study, these forms of mistreatment has been drastically reduced in our institute in addition to which good RMC practices are adopted, so that a woman can experience decent & ethical but an honourable start towards her motherhood. Conclusions: Training of HCPs to understand the concept of respectful maternity care, development of a handbook with standard operating protocols(14) for women in labour, introduction of different birthing positions as well as birth companions were described as key components to inculcating respectful maternity care. The programme was on going one, with respectful maternity care practices being passed on from older to newer staff through a system of continuous teaching and guidance on the job, hence institutionalising these new practices through constant engagement, supervision and incremental.

Increasing health facility childbirth in Ghana: the role of network and community norms

BackgroundReducing pregnancy-related deaths in Sub-Saharan Africa through increases in health facility births may be achieved by promoting community norms and network norms favoring health facility births. However, the process of how both norms shift attitudes and actions towards facility delivery is little studied. We examined the association of network and community norms with facility birth, following a quality improvement intervention to improve facility births in Ghana.MethodsA 2015 mixed methods evaluation of a Maternal and Newborn Health Referral (MNHR) project in Ghana included a cross-sectional survey of women (N = 508), aged 15–49 years; in-depth interviews (IDIs) with mothers (n = 40), husbands (n = 20) and healthcare improvement collaborative leaders (n = 8); and focus group discussions (FGDs) with mothers-in-law (n = 4) and collaborative members (n = 7). Multivariable logistic regression was used to examine the association of network and community norms with facility birth. Thematic analysis of the qualitative data was conducted to explain this relationship.ResultsThe network norm of perceived family approval of facility delivery (AOR: 5.54, CI: 1.65–18.57) and the community norm of perceived number of women in the community that deliver in a facility (AOR: 3.00, CI: 1.66–5.43) were independently associated with facility delivery. In qualitative IDIs and FGDs both norms were also collectively perceived as influencing facility delivery. However, network norms were more influential in women’s utilization of facility-based pregnancy-related care. Healthcare improvement collaboratives were important in swaying both network and community norms toward facility-based delivery by offering pregnancy-related health information, antenatal care, and support for facility delivery.ConclusionQuality improvement initiatives impact both community and network norms. To be most impactful in advancing facility-based pregnancy-related care, these initiatives should focus on highlighting the shifting trend toward facility delivery in rural communicates and promoting support for facility delivery among women’s personal networks.

Cultural beliefs and practices on perinatal death: a qualitative study among the Lango community in Northern Uganda

BackgroundPerinatal death has profound psychosocial effects on women and their families. Sociocultural contexts influence the burden, rituals and bereaved’s support. Little is known about cultural beliefs and practices related to perinatal death. This study explored the cultural perspectives of the Lango community on perinatal death.MethodsThis study utilised a focused ethnographic design anchored on a symbolic interactionist framework to understand the meanings attached to beliefs and practices on stillbirth or neonatal death among the Lango community in Lira District, Northern Uganda. Participants were sampled purposively for FGD while key informants were identified through snowballing technique. Data were audio recorded in Lango, transcribed, and later translated, a codebook was developed and data entered into Atlas. ti version 8.4.26 and then coded. It was analysed both deductively and inductively into themes.ResultsStillbirth and early neonatal death both attract similar rituals as would an older child. Burial is not rushed and is attended by family members and close friends. Stillbirths and children that die before naming are buried without names. Bereaved families are comforted and encouraged about future pregnancies. Currently, Lango associates the deaths to biomedical explanations such as teenage pregnancies, inadequate pregnancy care, health system challenges and poor health-seeking behaviour, unlike previously when they were attributed to consequences of unacceptable social behaviours, superstitious beliefs and witchcraft. Antenatal care and health facility childbirths are currently preferred over traditional practices for good pregnancy outcomes.ConclusionStillbirth or early neonatal death is viewed as the death of a child, different from other settings. Thus, rituals are performed to honour, create memory, and maintain the connection with deceased babies. Bereaved parents are supported. Health care workers need to provide culturally sensitive support to parents after perinatal loss. The prevailing beliefs of perinatal death cause in terms of biomedical explanations consistent with known determinants and preference for health facility care for prevention creates an opportunity for improving perinatal health.

A qualitative analysis of obstetric violence in rural Madagascar

In Madagascar, a country where maternal mortality remains high, the quality of obstetric care as perceived by users has been little explored. In this paper, we examine the perception of the quality of care in rural areas, by identifying women's experiences and expectations for basic and emergency obstetric care and how providers are meeting them. Data were collected in 2020, in three rural regions (Fenerive-Est, Manakara and Miandrivazo). 58 semi-structured interviews were conducted with women who had given birth in basic health centers or at home, and with other key informants including caregivers, birth attendants (known as matrones), grandmothers and community agents. 6 focus groups took place with mothers who had given birth at home and at a basic health centers and 6 observations took place during prenatal consultations. This article highlights the major dysfunctions perceived in the services offered and their influence on healthcare use. The women highlighted a lack of consideration of their expectations in obstetric care, with a defective caregiver/patient relationship, unforeseen costs and inadequate infrastructures incapable of guaranteeing intimacy. The women also complained of a lack of consideration of their fady (cultural prohibitions that can lead to misfortune) that surround pregnancy. These local practices conflict with the medical requirements of priority interventions in maternal care, and the respect of these practices by the women leads to reprimands and humiliation from caregivers. This obstetric violence, which emanates from the structure of society, gender relations and the biomedical practices governing pregnancy and childbirth in health facilities in Madagascar, constitutes an obstacle to the use of obstetric services. We hope that this description of the various dimensions of obstetric violence in Madagascar will make it possible to identify the structural obstacles limiting the capacity to provide quality care and to engender positive improvements in obstetric care in Madagascar.

Exploring women’s experiences during childbirth in health facilities during COVID-19 pandemic in occupied palestinian territory: a cross-sectional community survey

IntroductionThis study aims to assess the prevalence of mistreatment during childbirth in the occupied Palestinian territory and to explore factors associated with mistreatment.MethodsA cross-sectional study of women who gave birth in the West Bank and Gaza Strip health facilities. The survey was administered over the phone to women up to 8 weeks post-partum. Data collection took place between July 2020 and March 2021.ResultsA total of 745 women participated in the study, 36·25% were from the Gaza Strip and 63·75% from the West Bank. The prevalence of mistreatment was 18·8% in which women reported any verbal abuse, physical abuse, or stigma or discrimination during childbirth, with verbal abuse as the most common form of mistreatment reported. Physical abuse was more likely to be reported by women with no labour companion with them (OR: 3·11, 95%CI: 1·24 − 7·99). Verbal abuse was more likely to be reported by women with less than three live births (OR: 1·71, 95%CI: 1·06 − 2·76, women with no birth companion (OR: 2·72, 95%CI: 1·36 − 3·80) and more likely to be reported if curtains wre not used (OR: 2·55, 95%CI: 1·33 − 4·88). Women with less education were more likely to report long waiting times or delays in receiving services compared to women with higher education (OR: 1·40, 95%CI: 1·06 − 2·10).ConclusionFor the first time using the World Health Organisation (WHO) tool in the Eastern Mediterranean region, the study findings, show the occurrence of mistreatment and identify areas to be strengthened to ensure that all women have a respectful childbirth experience within health facilities.

Directly observed and reported respectful maternity care received during childbirth in public health facilities, Ibadan Metropolis, Nigeria.

Respectful maternity care (RMC) is believed to improve women’s childbirth experience and increase health facility delivery. Unfortunately, few women in low- and middle-income countries experience RMC. Patient surveys and independent observations have been used to evaluate RMC, though seldom together. In this study, we assessed RMC received by women using two methodologies and evaluated the associated factors of RMC received. This was a cross-sectional study conducted in nine public health facilities in Ibadan, a large metropolis in Nigeria. We selected 269 pregnant women by cluster sampling. External clinical observers observed them during childbirth using the 29-item Maternal and Child Health Integrated Program RMC observational checklist. The same women were interviewed postpartum using the 15-item RMC scale for self-reported RMC. We analysed total RMC scores and RMC sub-category scores for each tool. All scores were converted to a percentage of the maximum possible to facilitate comparison. Correlation and agreement between the observed and reported RMC scores were determined using Pearson’s correlation and Bland-Altman analysis respectively. Multiple linear regression was used to identify factors associated with observed RMC. No woman received 100% of the observed RMC items. Self-reported RMC scores were much higher than those observed. The two measures were weakly positively correlated (rho = 0.164, 95%CI: 0.045–0.278, p = 0.007), but had poor agreement. The lowest scoring sub-categories of observed RMC were information and consent (14.0%), then privacy (28.0%). Twenty-eight percent of women (95%CI: 23.0% -33.0%) were observed to be hit during labour and only 8.2% (95%CI: 4.0%-18.0%) received pain relief. Equitable care was the highest sub-category for both observed and reported RMC. Being employed and having completed post-secondary education were significantly associated with higher observed RMC scores. There were also significant facility differences in observed RMC. In conclusion, the women reported higher levels of RMC than were observed indicating that these two methodologies to evaluate RMC give very different results. More consensus and standardisation are required in determining the cut-offs to quantify the proportion of women receiving RMC. The low levels of RMC observed in the study require attention, and it is important to ensure that women are treated equitably, irrespective of personal characteristics or facility context.

Analysis of the Impact of Covid-19 on Pregnant Women on Preparation for Childbirth

All routine services, including maternal and newborn health services, face many constraints during this pandemic. In the early stages of pregnancy, almost every pregnant woman begins to prepare for labor. There are many things that can be done to prepare, from preparing for the needs of the baby, the needs of the mother, psychological preparation, to preparing for the choice of a birthing facility. Welcoming babies into families is a habit, but during the Covid-19 pandemic, it's another story. Objective: The purpose of this Systematic Review is to analyze the effect of immunization services during the COVID-19 pandemic. Methods: Database search includes Google Scholar, Science Direct, and Pubmed with the keywords used are impact, anxiety; pregnant mother; maternity mother; childbirth, pandemic, COVID-19. The next stage is to select articles according to the criteria, which are published in 2017-2022 with the full text of 12 articles that meet the inclusion criteria. Results: Findings from 12 articles showed that the impact of COVID-19 on the preparation of pregnant women for childbirth in health facilities differed from maternal anxiety. In addition, the anxiety of pregnant women about childbirth greatly affects the mother's readiness to carry out prenatal care and preparation for delivery. And the effects of Covid-19 on childbirth have not been shown to be contagious to the newborn. However, mothers who are infected with Covid-19 must still follow health protocols, including self-isolation or separation from their newborn babies. Conclusion: the impact of covid 19 on preparation for childbirth is the anxiety of pregnant women, This anxiety can be reduced by providing guidance, counseling and education for pregnant women about transmission and routes of transmission. How to protect yourself from COVID-19 and its prevention. It is transmitted from pregnant women to babies. More importantly, if the mother is hesitant and afraid to go for a pregnancy check-up at the hospital for fear of contracting the virus from other people, a solution can be given to check her womb at the nearest midwife or clinic so that she can avoid contact with other people as well as when the delivery process arrives.

Use of motorised transport and pathways to childbirth care in health facilities: Evidence from the 2018 Nigeria Demographic and Health Survey.

In Nigeria, 59% of pregnant women deliver at home, despite evidence about the benefits of childbirth in health facilities. While different modes of transport can be used to access childbirth care, motorised transport guarantees quicker transfer compared to non-motorised forms. Our study uses the 2018 Nigeria Demographic and Health Survey (NDHS) to describe the pathways to childbirth care and the determinants of using motorised transport to reach this care. The most recent live birth of women 15-49 years within the five years preceding the NDHS were included. The main outcome of the study was the use of motorised transport to childbirth. Explanatory variables were women's socio-demographic characteristics and pregnancy-related factors. Descriptive, crude, and adjusted logistic regression analyses were conducted to assess the determinants of use of motorised transport. Overall, 31% of all women in Nigeria used motorised transport to get to their place of childbirth. Among women who delivered in health facilities, 77% used motorised transport; among women referred during childbirth from one facility to another, this was 98%. Among all women, adjusted odds of using motorised transport increased with increasing wealth quintile and educational level. Among women who gave birth in a health facility, there was no difference in the adjusted odds of motorised transport across wealth quintiles or educational status, but higher for women who were referred between health facilities (aOR = 8.87, 95% CI 1.90-41.40). Women who experienced at least one complication of labour/childbirth had higher odds of motorised transport use (aOR = 3.01, 95% CI 2.55-3.55, all women sample). Our study shows that women with higher education and wealth and women travelling to health facilities because of pregnancy complications were more likely to use motorised transport. Obstetric transport interventions targeting particularly vulnerable, less educated, and less privileged pregnant women should bridge the equity gap in accessing childbirth services.

Prevalence of disrespect and abuse and its determinants during delivery in rural Uttar Pradesh India

Background: Disrespect and abuse treatment during childbirth in health facilities is a burning issue all over the world and emerged as a common problem in maternal health care. It is contributing to untold suffering and discouraging women from seeking care in health facilities. Women experiencing disrespect, abusive, or abandonment during childbirth is an international agenda. This study aims to estimate the prevalence of disrespect and abuse (D and VA) during delivery and identifies the associated factors.Methods: A community-based cross-sectional survey was conducted in the Balarampur district of Uttar Pradesh, India. The study included 364 women who underwent facility-based childbirth before six months of the survey. A multistage cluster sampling was used to select the potential participants of the study.Results: the findings of the study show Utmost every woman (98.5%) experienced any kind of disrespect or abuse during institutional delivery. However, 92% of women experienced non-consent care in which women were neither informed nor their verbal or written consent was taken before any medical procedures in the labor room. Disrespect and abuse during labor and delivery were significantly associated with Age group, religion, level of education, age at marriage, place of delivery, no. of ANC visit. Conclusions: Every woman has the right to receive kind and respectful maternity care, and mistreatment during maternal care services remains hindrance to achieving safe motherhood and child care.