Associations Between Mistreatment by a Provider during Childbirth and Maternal Health Complications in Uttar Pradesh, India
Objectives This study assesses associations between mistreatment by a provider during childbirth and maternal complications in Uttar Pradesh, India. Methods Cross-sectional survey data were collected from women (N = 2639) who had delivered at 68 public health facilities in Uttar Pradesh, participati...
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Published in | Maternal and child health journal Vol. 21; no. 9; pp. 1821 - 1833 |
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Main Authors | , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York
Springer US
01.09.2017
Springer Springer Nature B.V |
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Abstract | Objectives
This study assesses associations between mistreatment by a provider during childbirth and maternal complications in Uttar Pradesh, India.
Methods
Cross-sectional survey data were collected from women (N = 2639) who had delivered at 68 public health facilities in Uttar Pradesh, participating in a quality of care study. Participants were recruited from April to July 2015 and surveyed on demographics, mistreatment during childbirth (measure developed for this study, Cronbach’s alpha = 0.70), and maternal health complications. Regression models assessed associations between mistreatment during childbirth and maternal complications, at delivery and postpartum, adjusting for demographics and pregnancy complications.
Results
Participants were aged 17–48 years, and 30.3% were scheduled caste/scheduled tribe. One in five (20.9%) reported mistreatment by their provider during childbirth, including discrimination and abuse; complications during delivery (e.g., obstructed labor) and postpartum (e.g., excessive bleeding) were reported by 45.8 and 41.5% of women, respectively. Health providers at delivery included staff nurses (81.8%), midwives (14.0%), and physicians (2.2%); Chi square analyses indicate that women were significantly more likely to report mistreatment when their provider was a nurse rather than a physician or midwife. Women reporting mistreatment by a provider during childbirth had higher odds of complications at delivery (AOR = 1.32; 95% CI 1.05–1.67) and postpartum (AOR = 2.12; 95% CI 1.67–2.68).
Conclusions for Practice
Mistreatment of women by their provider during childbirth is a pervasive health and human rights violation, and is associated with increased risk for maternal health complications in Uttar Pradesh. Efforts to improve quality of maternal care should include greater training and monitoring of providers to ensure respectful treatment of patients. |
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AbstractList | Objectives This study assesses associations between mistreatment by a provider during childbirth and maternal complications in Uttar Pradesh, India. Methods Cross-sectional survey data were collected from women (N=2639) who had delivered at 68 public health facilities in Uttar Pradesh, participating in a quality of care study. Participants were recruited from April to July 2015 and surveyed on demographics, mistreatment during childbirth (measure developed for this study, Cronbach's alpha=0.70), and maternal health complications. Regression models assessed associations between mistreatment during childbirth and maternal complications, at delivery and postpartum, adjusting for demographics and pregnancy complications. Results Participants were aged 17-48 years, and 30.3% were scheduled caste/scheduled tribe. One in five (20.9%) reported mistreatment by their provider during childbirth, including discrimination and abuse; complications during delivery (e.g., obstructed labor) and postpartum (e.g., excessive bleeding) were reported by 45.8 and 41.5% of women, respectively. Health providers at delivery included staff nurses (81.8%), midwives (14.0%), and physicians (2.2%); Chi square analyses indicate that women were significantly more likely to report mistreatment when their provider was a nurse rather than a physician or midwife. Women reporting mistreatment by a provider during childbirth had higher odds of complications at delivery (AOR=1.32; 95% CI 1.05-1.67) and postpartum (AOR=2.12; 95% CI 1.67-2.68). Conclusions for Practice Mistreatment of women by their provider during childbirth is a pervasive health and human rights violation, and is associated with increased risk for maternal health complications in Uttar Pradesh. Efforts to improve quality of maternal care should include greater training and monitoring of providers to ensure respectful treatment of patients. Objectives This study assesses associations between mistreatment by a provider during childbirth and maternal complications in Uttar Pradesh, India. Methods Cross-sectional survey data were collected from women (N = 2639) who had delivered at 68 public health facilities in Uttar Pradesh, participating in a quality of care study. Participants were recruited from April to July 2015 and surveyed on demographics, mistreatment during childbirth (measure developed for this study, Cronbach's alpha = 0.70), and maternal health complications. Regression models assessed associations between mistreatment during childbirth and maternal complications, at delivery and postpartum, adjusting for demographics and pregnancy complications. Results Participants were aged 17-48 years, and 30.3% were scheduled caste/scheduled tribe. One in five (20.9%) reported mistreatment by their provider during childbirth, including discrimination and abuse; complications during delivery (e.g., obstructed labor) and postpartum (e.g., excessive bleeding) were reported by 45.8 and 41.5% of women, respectively. Health providers at delivery included staff nurses (81.8%), midwives (14.0%), and physicians (2.2%); Chi square analyses indicate that women were significantly more likely to report mistreatment when their provider was a nurse rather than a physician or midwife. Women reporting mistreatment by a provider during childbirth had higher odds of complications at delivery (AOR = 1.32; 95% CI 1.05-1.67) and postpartum (AOR = 2.12; 95% CI 1.67-2.68). Conclusions for Practice Mistreatment of women by their provider during childbirth is a pervasive health and human rights violation, and is associated with increased risk for maternal health complications in Uttar Pradesh. Efforts to improve quality of maternal care should include greater training and monitoring of providers to ensure respectful treatment of patients. Objectives This study assesses associations between mistreatment by a provider during childbirth and maternal complications in Uttar Pradesh, India. Methods Cross-sectional survey data were collected from women (N = 2639) who had delivered at 68 public health facilities in Uttar Pradesh, participating in a quality of care study. Participants were recruited from April to July 2015 and surveyed on demographics, mistreatment during childbirth (measure developed for this study, Cronbach’s alpha = 0.70), and maternal health complications. Regression models assessed associations between mistreatment during childbirth and maternal complications, at delivery and postpartum, adjusting for demographics and pregnancy complications. Results Participants were aged 17–48 years, and 30.3% were scheduled caste/scheduled tribe. One in five (20.9%) reported mistreatment by their provider during childbirth, including discrimination and abuse; complications during delivery (e.g., obstructed labor) and postpartum (e.g., excessive bleeding) were reported by 45.8 and 41.5% of women, respectively. Health providers at delivery included staff nurses (81.8%), midwives (14.0%), and physicians (2.2%); Chi square analyses indicate that women were significantly more likely to report mistreatment when their provider was a nurse rather than a physician or midwife. Women reporting mistreatment by a provider during childbirth had higher odds of complications at delivery (AOR = 1.32; 95% CI 1.05–1.67) and postpartum (AOR = 2.12; 95% CI 1.67–2.68). Conclusions for Practice Mistreatment of women by their provider during childbirth is a pervasive health and human rights violation, and is associated with increased risk for maternal health complications in Uttar Pradesh. Efforts to improve quality of maternal care should include greater training and monitoring of providers to ensure respectful treatment of patients. |
Audience | Academic |
Author | Singh, Kultar Shetye, Mrunal Seth, Aparna Ramakrishnan, Aparajita Saggurti, Niranjan Bora, Siddhartha Das, Arup Kumar Silverman, Jay G. Chakraverty, Amit Boyce, Sabrina Chandurkar, Dharmendra Dey, Arnab Hay, Katherine Raj, Anita |
Author_xml | – sequence: 1 givenname: Anita surname: Raj fullname: Raj, Anita email: anitaraj@ucsd.edu organization: Center on Gender Equity and Health, Division of Global Public Health, University of California, San Diego School of Medicine – sequence: 2 givenname: Arnab surname: Dey fullname: Dey, Arnab organization: Sambodhi Research and Communications Pvt. Ltd – sequence: 3 givenname: Sabrina surname: Boyce fullname: Boyce, Sabrina organization: Center on Gender Equity and Health, Division of Global Public Health, University of California, San Diego School of Medicine – sequence: 4 givenname: Aparna surname: Seth fullname: Seth, Aparna organization: Sambodhi Research and Communications Pvt. Ltd – sequence: 5 givenname: Siddhartha surname: Bora fullname: Bora, Siddhartha organization: Sambodhi Research and Communications Pvt. Ltd – sequence: 6 givenname: Dharmendra surname: Chandurkar fullname: Chandurkar, Dharmendra organization: Sambodhi Research and Communications Pvt. Ltd – sequence: 7 givenname: Katherine surname: Hay fullname: Hay, Katherine organization: Bill and Melinda Gates Foundation – sequence: 8 givenname: Kultar surname: Singh fullname: Singh, Kultar organization: Sambodhi Research and Communications Pvt. Ltd – sequence: 9 givenname: Arup Kumar surname: Das fullname: Das, Arup Kumar organization: India Health Action Trust – sequence: 10 givenname: Amit surname: Chakraverty fullname: Chakraverty, Amit organization: Sambodhi Research and Communications Pvt. Ltd – sequence: 11 givenname: Aparajita surname: Ramakrishnan fullname: Ramakrishnan, Aparajita organization: Bill and Melinda Gates Foundation – sequence: 12 givenname: Mrunal surname: Shetye fullname: Shetye, Mrunal organization: Bill and Melinda Gates Foundation – sequence: 13 givenname: Niranjan surname: Saggurti fullname: Saggurti, Niranjan organization: Bill and Melinda Gates Foundation – sequence: 14 givenname: Jay G. surname: Silverman fullname: Silverman, Jay G. organization: Center on Gender Equity and Health, Division of Global Public Health, University of California, San Diego School of Medicine |
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This study assesses associations between mistreatment by a provider during childbirth and maternal complications in Uttar Pradesh, India.
Methods... Objectives This study assesses associations between mistreatment by a provider during childbirth and maternal complications in Uttar Pradesh, India. Methods... |
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SubjectTerms | Adult Attitude of Health Personnel Beliefs, opinions and attitudes Care and treatment Childbirth & labor Delivery (Childbirth) Delivery, Obstetric - methods Delivery, Obstetric - psychology Discrimination (Psychology) Female Gynecology Health aspects Health Personnel - psychology Health Services Accessibility Human rights Humans India - epidemiology Maternal & child health Maternal and Child Health Maternal health services Medical personnel Medicine Medicine & Public Health Middle Aged Mothers Nurse Midwives - psychology Parturition - psychology Pediatrics Physicians - psychology Population Economics Postpartum Hemorrhage - epidemiology Pregnancy Pregnancy Complications - epidemiology Professional-Patient Relations Public Health Quality of Health Care Services Social Class Sociology Womens health |
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Title | Associations Between Mistreatment by a Provider during Childbirth and Maternal Health Complications in Uttar Pradesh, India |
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