A qualitative systematic review of women's perception and experiences of disrespectful maternity care

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Background During pregnancy and childbirth, a woman's connection with maternity care professionals and the maternity care system is critical to her and her unborn child's safety. The connection between woman and the maternity care services/personnel can be impacted when women are subjected to unhuman, disrespectful, and abusive treatment by maternity healthcare providers. There is an increased report worldwide of disrespect and abuse to women during utilisation of maternity care. Despite, this research in the area remains limited, with little focus on the experience from the women’s perception. Therefore, this review is the first qualitative review that consolidates the women perception regarding this phenomenon.  Aim To systematically review and critically appraise women’s perceptions and experiences of disrespectful maternity care worldwide. Objectives The objectives of the review are to explore: Women’s expereinces of disrespectful maternity care. The factors contributing to disrespect when seeking maternal healthcare services according to women's accounts. The consequences of disrespect and abuse on future utilization of skilled care. Methodology Six databases (Maternity & Infant Care , PubMed, MEDLINE, Scopus, CINAHL, and Web of Science) were systematically searched for suitable literature from 2014-present. Primary qualitative research that focused on disrespectful maternity care and captured women's experiences and perceptions were qualified. To address the studies quality CASP tool was used. Findings This review included nine qualitative study voicing the women perception. The studies ranged from medium to high methodological quality. The review used Bowser and Hill 2010 framework used to aid the identification of the themes and subthemes. Four themes emerged from the analysis: Experiences and perceptions of mistreatment during maternity care, Typology of mistreatment during maternity care, Perceived contributors and consequences to the experienced disrespect and abuse. Conclusion The review found that mistreatment and abuse to women receiving maternity care is an issue in both low-income and high-income countries worldwide. The types of disrespect and abuse vary according to the income of each county. In high income countries non-dignified care and non-consented were the most reported form of mistreatment. Meanwhile, in low-income country women reported experience of the seven categories of mistreatment. Women perceived lack of healthcare facility resources, lack of staff and social violence as contributor to this phenomenon. Women consider this experience as dehumanizing and violating human rights and influenced their decision to utilise skilled care in the future.
Maternal health, Maternity Care, Quality of care, Disrespect and abuse, Mistreatment, Discrimination, Obstetric Violence