The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review
By Meghan A. Bohren, Joshua P. Vogel, E. Hunter, Olha Lutsiv, Suprita K. Makh, J. Souza, C. Aguiar, Fernando Saraiva Coneglian, Alex Luís Araujo Diniz, Ö. Tunçalp and 5 more. PLoS Medicine, 2015
1,407 citations recorded by the source corpus.
Background Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon. Methods and Findings We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology. Conclusions This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools and inform future research, programs, and interventions.
Subfields: Clinical Psychology, Health, Obstetrics and Gynecology
View Paper: https://www.semanticscholar.org/paper/afa79083c48a5860d9db6a6a2f323e59c6c48bfa
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Citations in the corpus
- Using Qualitative Evidence in Decision Making for Health and Social Interventions: An Approach to Assess Confidence in Findings from Qualitative Evidence Syntheses (GRADE-CERQual) (2015, methodology): “The current version of CERQual has been used in one published review [36] and is currently being used in a further ten reviews, at least half of which are being produced to support WHO guidance.”
- Economic Self-Help group Programs for Improving Women's Empowerment: A Systematic Review (2015, methodology): “The process of assessment of confidence we use is in alignment with the methodology used in Bohren et al. (2015).”
- The Giving Voice to Mothers study: inequity and mistreatment during pregnancy and childbirth in the United States (2019, methodology): “The investigators identified multiple examples of disrespect and human rights violations experienced by women giving birth, ranging from physical and verbal abuse, to a lack of supportive care, to neglect, discrimination, and denial of autonomy [13].”
- Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series (2018, background): “So far, experience in using CERQual has been concentrated in reviews with findings that are aggregative in nature, for example, related to health care users’ and providers’ experiences and understanding of health issues and health service delivery [6, 7, 28, 29, 31].”