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Maternal and Child Health Journal

, Volume 21, Issue 9, pp 1821–1833 | Cite as

Associations Between Mistreatment by a Provider during Childbirth and Maternal Health Complications in Uttar Pradesh, India

  • Anita Raj
  • Arnab Dey
  • Sabrina Boyce
  • Aparna Seth
  • Siddhartha Bora
  • Dharmendra Chandurkar
  • Katherine Hay
  • Kultar Singh
  • Arup Kumar Das
  • Amit Chakraverty
  • Aparajita Ramakrishnan
  • Mrunal Shetye
  • Niranjan Saggurti
  • Jay G. Silverman
Article

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.

Keywords

Maternal health Childbirth Abuse Discrimination India 

Notes

Acknowledgements

This study was funded by the Bill and Melinda Gates Foundation Grant No. OPP1083531.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Anita Raj
    • 1
  • Arnab Dey
    • 2
  • Sabrina Boyce
    • 1
  • Aparna Seth
    • 2
  • Siddhartha Bora
    • 2
  • Dharmendra Chandurkar
    • 2
  • Katherine Hay
    • 3
  • Kultar Singh
    • 2
  • Arup Kumar Das
    • 4
  • Amit Chakraverty
    • 2
  • Aparajita Ramakrishnan
    • 3
  • Mrunal Shetye
    • 3
  • Niranjan Saggurti
    • 3
  • Jay G. Silverman
    • 1
  1. 1.Center on Gender Equity and Health, Division of Global Public HealthUniversity of California, San Diego School of MedicineLa JollaUSA
  2. 2.Sambodhi Research and Communications Pvt. Ltd.NoidaIndia
  3. 3.Bill and Melinda Gates FoundationNew DelhiIndia
  4. 4.India Health Action TrustNew DelhiIndia

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