Most of pregnant women face ‘abuse’ at health care facilities

The researchers came across seven types of maltreatment and abuse that pregnant women were subjected to.

The majority of pregnant women seeking maternity care in government and private healthcare centres in northern India are subjected to a variety of abuse and maltreatment, a study has revealed.

The study which made the shocking revelation was conducted by experts from the school of public health of the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh.

The study

This study “Respectful Maternity Care at Primary, Secondary and Tertiary Care Facilities: A Study for Advocacy” was conducted in Chandigarh, Punjab, Haryana, Jammu and Kashmir and Himachal Pradesh.

It was conducted between May and August 2017 in 11 government and five private health facilities that provide maternity care and a total of 200 women were surveyed. The most common form of abuse included pregnant women being shouted at by the hospital staff, left unattended or instances of hurried check-ups.

Seven Types of Abuse

The researchers came across seven types of maltreatment and abuse that pregnant women were subjected to:

Neglect or denial of care: Instances of neglect, abandonment or denial of care were observed. Cases of denial of care included failure on the part of nurses to provide comfort to the client, ignoring client’s calls for help, not responding to client’s expressions of pain, lack of cleanliness and hygiene, leaving women unattended in labour rooms, and family members performing roles of health staff.

Verbal abuse: In most of the cases, cases of undignified care included rough treatment, display of impatience, passing rude and harsh comments, judgmental comments, treating the patient as a passive participant.

Non-consented care: Denial of birth companion in the second or third stage of labour, lack of information about care being provided or findings of physical examination were most commonly identified forms of disrespect and abuse. Also, participants were concerned about the lack of information provided on the consent-seeking process.

Physical abuse: Strenuous pressure on the abdomen during delivery and physical handling were the most commonly observed forms of this.

Discrimination based on social status: Discrimination based on socioeconomic status was the most prevalent maltreatment. Women also reported discrimination based on ethnicity and their level of education.

Detention in facilities: The researchers could not find any direct evidence for detention in HCF in any of the childbirth observed. However, demands for informal payments by the health staff were observed, amounting to a kind of detention.

Non-confidential care: Instances of non-confidential care were reported. Similarly, instances of pregnant women getting exposed to other women lying in the labour ward and non-health male allied staff’s presence in the room were observed.

Hospitals in denial mode

The report says that most of the health care providers denied any abuse in their facilities. They attributed such instances to high-patient load, poor patient-staff ratio, work culture and uncooperative patients.

Even though the service providers were aware of the government’s notification that allows a birth companion during delivery, they did not allow it as they felt that birth companions will distract women.

PGIMER called stakeholders to discuss the issue

The stakeholders’ meeting was called at the PGIMER to discuss respectful maternity care and devise an action plan to ensure this.

It was attended by gynaecologists, nurses, representatives of obstetrics and gynaecology departments of medical colleges, civil society members and academicians from PGIMER and other states.

PGIMER dean (academics) Dr Rajesh Kumar said, “This is a first step towards providing respectful maternity care services. Our purpose is to solve the problem and not to blame institutions.”

Source: hindustantimes