“At Least Your Baby Is Healthy” Obstetric Violence or Disrespect and Abuse in Childbirth Occurrence Worldwide: A Literature Review

Obstetric violence or disrespect and abuse in childbirth is a worldwide phenomenon that takes on various forms, from absence of informed consent to physical harm. The objective of this review is to assess prevalence and root causes of obstetric violence in different countries, and potential solutions to address disrespect and abuse in childbirth. The review finds that obstetric violence is rooted in a patriarchal understanding of gender stereotypes and is exacerbated by power dynamics between health professionals and patients, especially for minorities. Obstetric violence has a long-lasting impact on women’s lives and can jeopardize subsequent decisions to access healthcare services.

Patient and Provider Perspectives of Disrespect and Abuse during Childbirth in Tanzania: A Literature Review

Objective: Disrespectful and abusive (D&A) maternity care is a deterrent to facility childbirth and can thus contribute to child and maternal mortality. This study will review existing literature on D&A in Tanzania to better understand and contextualize the issue. Methods: A comprehensive literature search was conducted to find relevant publications on D&A during childbirth in Tanzania. The search was conducted on the National Center for Biotechnology Information (NCBI) and PubMed (U.S. National Library of Medicine at the National Institutes of Health). The inclusion criteria were as follows: qualitative, quantitative, and ethnographic studies conducted in Tanzania on obstetrical violence;published in English;focused on prevalence, incidence, root causes, historical trends, interventions, and policy recommendations for obstetrical violence in Tanzania. Results: Twenty-one studies were selected for this literature review. Up to 73.1% of women reported experiencing at least one form of D&A during labor. Commonly reported D&A events include non-dignified care, non-confidential care, and physical abuse. Other forms of D&A, including detention in facilities and asking for unofficial payments, are also reported. Ninety-six percent of nurses, midwives, and nursing assistants in Tanzania self-reported engaging in at least one form of D&A. Lack of training and provider support, long work hours, fear of blame, and limited infrastructure were reported as factors leading to D&A by providers. Conclusions: In Tanzania, D&A during childbirth is prevalent in healthcare systems. The direct relationship between D&A and poor maternal and fetal health is well-documented. Individual and systemic factors influence both provider and patient perspectives of D&A, providing a window into a complex and sensitive phenomenon. It is important that D&A in Tanzania be viewed holistically, and that interventions target the multifaceted nature of the issue.