Disrespectful Maternity Care and Abuse During Childbirth: Exploring Perceptions and Experiences of Women Delivered at a Tertiary Hospital in Abakaliki, Nigeria.

Background: An important but little understood component of poor care that women receive during antenatal care and childbirth is disrespect and abuse perpetuated by health workers. Fear of experiencing disrespect and abuse has a negative influence on women’s decision to seek care at a health facility during pregnancy, labour and delivery. The objective of this study is to determine the prevalence, pattern and predictors of disrespect and abuse during labour and delivery.

Methods: This is a questionnaire-based cross-sectional study conducted from February 1, 2019, to July 31, 2019, among postnatal women delivered at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Data were analyzed using SPSS version 22.

Results: The prevalence of disrespectful maternity care and abuse was 47.6%. The forms of disrespect and abuse experienced by the participants were detention in the health facility (40.2%), physical abuse (34.1%), non-dignified care (37.2%), non-consented care (20.1%), abandonment of care (18.9%), non-confidential care (25%) and discriminatory care (15.2%). Lack of companionship during delivery (AOR: 7.01, 95%CI: 1.27-4.49; p = 0.007), unbooked status (AOR: 2.37, 95%Cl: 0.31 - 0.92; p = 0.01) and rural residence (AOR = 4.52 95% CI: 2.33-8.75, P<0.0001) were factors associated with disrespect and abuse during childbirth.

Conclusion: Disrespectful maternity care and abuse during childbirth among women seeking maternity care are still prevalent (47.6%) in our hospital. Educating health workers on the importance of respectful maternity care would ensure acceptable, quality and dignified care for all women seeking maternity care in our facility.

【背景】女性在产前保健与分娩期间所接受的劣质照护中，有一个重要却鲜为人知的构成要素，即医护人员实施的不尊重与侵害行为。担忧遭受此类不尊重与侵害，会对女性在孕期、产程及分娩阶段选择医疗机构寻求照护的决策产生负面影响。本研究旨在明确产程与分娩期间不尊重与侵害行为的流行率、发生类型及影响因素。

【方法】本研究为基于问卷的横断面研究，于2019年2月1日至2019年7月31日期间，针对在阿巴卡利基市亚历克斯·埃克韦梅联邦大学教学医院分娩的产后妇女开展。采用SPSS 22.0版本对数据进行统计分析。

【结果】不尊重式分娩照护与侵害行为的流行率为47.6%。研究对象所遭遇的不尊重与侵害行为类型包括：滞留医疗机构（40.2%）、躯体虐待（34.1%）、非尊严照护（37.2%）、未获同意的照护（20.1%）、遗弃照护（18.9%）、非保密照护（25%）及歧视性照护（15.2%）。分娩期间无陪护（调整后比值比（Adjusted Odds Ratio, AOR）：7.01，95%置信区间（95% Confidence Interval, 95%CI）：1.27~4.49；P=0.007）、未建档待产状态（AOR：2.37，95%CI：0.31~0.92；P=0.01）及农村居住地（AOR=4.52，95%CI：2.33~8.75，P<0.0001）为与分娩期间不尊重与侵害行为相关的危险因素。

【结论】本医院内寻求分娩照护的女性所遭遇的产时不尊重照护与侵害行为仍较为普遍，流行率达47.6%。对医护人员开展尊重式分娩照护重要性的教育培训，能够为本机构内所有寻求分娩照护的女性提供可接受、高质量且富有尊严的照护服务。