Disrespect and abuse during facility‐based childbirth in central Ethiopia

Figures & data

Table 1. Sociodemographic characteristics of participants (N = 435)

Variables		Frequency	Percentage
Age in Years	18–19	14	3.2
	20–24	78	17.9
	25–29	179	41.1
	30–34	90	20.7
	35+	74	27.0
Residence	Urban	304	69.9
	Rural	131	30.1
Marital status	Single	25	5.7
	Married	378	86.9
	Divorced	24	5.5
	Widowed	8	1.8
Level of education	No formal education	105	24.1
	Primary education	124	28.5
	Secondary education	106	24.4
	Tertiary education	100	23.0
Occupational status	Housewife	201	46.2
	Government employee	99	22.8
	Private employee	113	26
	Farmer	22	5.1
Monthly household income	≥ 1,644	77	17.7
	Less than 1,644	358	82.3
Spouse occupation	Unemployed	16	3.7
	Private employee	137	31.5
	Farmer	45	10.3
	Government employee	180	41.4

*1 USD was equivalent to 28.85 ETH birr during the study period and then multiplied by poverty line income (1.9/day).

Table 2. Obstetric history of participants (N = 435)

Variables		Frequency	Percentage
Walking distance of health facility from home in minutes	<30	145	33.3
	30–60	248	57.0
	>60	42	9.7
Total number of live births	1–3	354	81.4
	≥4	81	18.6
Number of births at health facility	1	119	27.4
	≥2	316	72.6
Antenatal follow up for recent pregnancy	Yes	395	90.8
	No	40	9.2
Antenatal and childbirth in same facility for recent birth (N = 395)	Yes	345	87.3
	No	50	12.7
Type of health facility visited for birth	Health Centre	223	51.3
	Hospital	212	48.7
Method of birth for recent childbirth	Vaginal delivery	391	89.9
	Caesarean section	44	10.1
Number of babies in most recent childbirth	One baby (single)	405	93.1
	Two babies (twin)	30	6.9
Profession of provider who attended the birth	Doctor	99	22.8
	Midwifery nurse	255	58.6
	I do not know	81	18.6
Sex of provider who attended the birth	Male	217	49.9
	Female	218	50.1

Figure 1. Categories of disrespect and abuse reported by women (N = 435)

Table 3. Experiences of disrespect and abuse during facility-based childbirth, Ethiopia, 2020 (N = 435)

Types of D&A	N	%
Experienced at least one form of D&A	435	100
Physical abuse	435	100
Pinched/kicked/slapped	34	7.8
Hit with an instrument	12	2.8
Gagged to prevent from speaking/ making noise	41	9.4
Restrained or tied down during labor	32	7.4
Fundal pressure applied	75	17.2
Preferred birthing position not allowed	413	94.9
Episiotomy given or sutured without anesthesia	381	87.6
Not allowed to move around during labour	277	63.7
Had no access to water or other oral fluids	108	24.8
Not allowed to eat without medical indication	219	50.3
Non-dignified care	126	29
Shouted/ screamed at	71	16.3
Insulted/ scolded/ mocked	44	10.1
Received negative comments about your/your baby’s physical appearance	37	8.5
Received negative comments regarding your sexual activity	32	7.4
Threatened with a physical violence or unfavorable medical procedures	59	13.6
Threatened with poor outcome to comply	75	17.2
Threatened to withhold care	55	12.6
Blamed or intimidated during childbirth	17	3.9
Hissed at	36	8.3
Non-consented care	423	97.2
Vaginal examination not explained	126	29.0
Non-consented vaginal examination	362	83.2
Vaginal examination not done privately	152	34.9
Non-consented episiotomy	58	13
IUD insertion	92	21.1
Augmentation of labor	97	22.3
Non-confidential care	288	66.2
Staff discussed private information in a way that others could hear	54	12.4
Lack/misuse of curtains to provide privacy	220	50.6
Do not have bed during labor	89	20.5
Do not have during childbirth	73	16.8
Shared bed with another woman or women	31	7.1
Vaginal examinations not conducted privately	204	46.9
Neglect/ abandonment	151	34.7
Providers not present when the baby came out	56	12.9
Felt ignored by the health workers or staff	111	25.5
Waited for long before attended by a provider	107	24.6
Felt emotionally unsupported by providers	64	14.7
Providers did not listen to my concerns	77	17.7
Providers did not respond to my concerns	84	19.3
Disallowed to have a birth companion	91	20.9
Discrimination	99	22.8
Received negative comments regarding your ethnicity/ religion	7	1.6
Received negative comments regarding your age	37	8.5
Received negative comments regarding your marital status	11	2.5
Received negative comments regarding your level of literacy	22	5.1
Received negative comments regarding your economic circumstance	24	5.5
Received negative comments regarding your HIV seropositive status	51	11.7
Denied a language interpreter	13	3
Detention	24	5.5
Detained in the hospital due to inability to pay hospital bills	17	3.9
Instructed to clean up own blood or other fluid after birth	13	3.0
Asked for a bribe, informal payment/ gift	11	2.5

Table 4. Bivariate and multivariate logistic regression analysis output of factors associated with disrespect and abuse during facility-based childbirth, North Showa zone, Ethiopia, 2019

Variables with categories	Non-dignified care AOR [CI]	Non-confidential care AOR [CI]	Discriminatory care AOR [CI]	Abandonment AOR [CI]
Level of education
Tertiary	1	1	1	1
No education	1.41 (0.61–3.26)	2.12 (0.96–4.67)	1.59 (0.72–3.51)	1.08 (0.51–2.27)
Primary	2.04 (0.90–4.62)	2.15 (1.01–4.55)*	0.89 (0.39–2.01)	1.15 (0.55–2.37)
Secondary	1.58 (0.69–3.65)	2.24 (1.09–4.60)*	1.60 (0.75–3.44)	1.42 (0.69–2.90)
Residence
Urban	1	1	1	1
Rural	3.65 (2.11–6.32)*	1.44 (0.76–2.71)	1.07 (0.59–1.92)	1.77 (1.04–3.02)*
Household monthly income
≥1644	1	1	1	1
Less than 1644	5.29 (1.94–14.42)*	2.26 (1.20–4.26)*	2.82 (1.11–7.11)*	1.73 (0.83–3.56)
Type of health facility visited for birth care
Health center	1	1	1	1
Hospital	1.75 (1.04–2.94)*	3.04 (1.75–5.27)*	2.16 (1.24–3.77)*	2.58 (1.57–4.25)*
Profession of provider attended birth
Doctor	1	1	1	1
Midwifery nurse	2.23 (1.13–4.39)*	3.43 (1.90–6.18)*	2.49 (1.14–5.46)*	0.87 (0.45–1.59)
I don’t know	1.95 (0.84–4.54)	4.00 (1.79–8.93)*	3.91 (1.59–9.58)*	0.50 (0.23–1.10)
Sex of provider attended the birth
Male	1	1	1	1
Female	1.74 (1.06–2.86)*	4.21(2.52–7.03)*	0.78 (0.47–1.30)	4.0 4(2.51–6.50)*

*Significantly associated at p value of <0.05.