Researchers observed a total of 2,016 women from the moment they were admitted to a medical facility until two hours after childbirth. Another 2,672 follow-up surveys were carried out up until eight weeks post partum. All participants were at least 15 years of age and were recruited to join the study between September 2016 and January 2018.
Among the women who were observed during childbirth, officials found that more than 40% of the expectant mothers were either physically or verbally abused or experienced discrimination due to their race or ethnicity, noting that some women were slapped, hit and even punched while in labor. In 39 of the observed cases, women were forcefully held down on the bed.
Researchers stated in their findings that the highest rate of verbal abuse was found within Nigerien medical facilities, where the most common forms of said abuse were cases in which women were shouted at, scolded and mocked.
“Physical and verbal abuse peaked 30 [minutes] before birth until 15 [minutes] after birth and were most highly concentrated during the 15-[minute] period before birth,” reads the study. “Women were more likely to be physically abused within 15 [minutes] before birth and 15 [minutes] after birth, compared with 45-60 [minutes] before birth, adjusting for country differences.”
“Verbal abuse was elevated 15-30 [minutes] before birth, highest within 15 [minutes] before birth, and still elevated within 15 [minutes] after birth,” it added.
Shockingly, in the 75 of the 2,016 observed cases, no medical staff were present when the mother birthed her child; seven of the mothers were “instructed to clean up blood, urine, faeces, or amniotic fluid,” and in another 62 cases, staff members either suggested or asked the mother or her companion for a “bribe, informal payment or gift.”
In terms of unwanted medical procedures, researchers pointed out that across all women who participated in the study, 2,611 vaginal examinations were conducted without their consent. When it came to caesarean births, 87 women had the procedure without their prior approval, and in the cases where an episiotomy - a surgical cut made during childbirth at the opening of the vagina - was conducted, 242 mothers went under the knife without agreeing to the procedure.
In 199 cases, despite having asked for painkillers, expectant mothers were not given any form of medication to alleviate the labor pains.
“Younger, less educated women were at highest risk, highlighting the need for multilevel interventions. Addressing these inequalities and promoting respectful maternity care for all are key to improve health equity and quality,” the study concludes. “Action is urgently needed to enhance the provision of respectful maternity care worldwide.”
Per WHO’s suggestions, in order to tackle the mistreatment of women during childbirth, health facilities have to be held accountable, and additional resources need to be made available to medical centers so that they can provide the utmost care for women.