Why expectant women shun hospitals

One in five women suffers severe physical and verbal abuse during labour and delivery at public hospitals, a new study says. PHOTO | FILE 

In Summary

• Researchers interviewed 641 mothers at 13 purposely selected facilities in Kisumu, Kiambu, Nyandarua and Uasin Gishu, and one maternity hospital in Nairobi.
• “Understanding the prevalence of disrespect and abuse is critical in developing interventions at national, health facility and community levels,” the report says.
• It asserts that disrespect and abuse in childbirth is a critical but little discussed subject which is a major barrier in helping increase the number of expectant mothers who seek medical assistance, with many unaware that what they go through is a serious human rights violation as well as criminal in nature.

One in five women suffers severe physical and verbal abuse during labour and delivery at public hospitals, a new study says.

The study, funded by the United States Agency for International Development, says the government’s pledge to provide free maternity services is hampered by rude and violent health workers who make women shun hospitals, endangering their babies’ as well as their own lives.

Researchers interviewed 641 mothers at 13 purposely selected facilities in Kisumu, Kiambu, Nyandarua and Uasin Gishu, and one maternity hospital in Nairobi.

The study says the presence of spouses in the delivery room could curb the “mistreatment” and is now considered a norm by mothers.

It says key manifestations of abuse include pinching, slapping and beating, non-consensual care (coerced Caesarean sections), non-dignified care, verbal abuse, discrimination towards poor and young mothers, abandonment of women during and after labour, and detention because of inability to pay hospital fees.

The research protocol approved by the Division of Reproductive Health, Ministry of Health, Kenya Medical Research Institute, Ethical Review Board and the Population Council’s Institutional Review Board urges an open reporting system that will help the Health ministry formulate measures to curb the abuse.

FEAR OF BEING INSULTED

“Understanding the prevalence of disrespect and abuse is critical in developing interventions at national, health facility and community levels,” the report says.
The study, published this month, says women did not attend hospitals for fear of being insulted, assaulted, or abandoned.

“Patient abuse was most commonly documented during labour in maternity units, where nurses occasionally shout at women or slap or pinch them. A total of 115 reported being treated with disrespect, which made them feel unwanted.

“Hardest hit are under 19-year-olds who are openly abused mainly for unwanted pregnancies while those whose HIV status is known are openly addressed in the main ward. While 155 reported verbal abuse, 81 spoke of being abandoned and 48 said no one responded to their plea of pain,” it says.

It asserts that disrespect and abuse in childbirth is a critical but little discussed subject which is a major barrier in helping increase the number of expectant mothers who seek medical assistance, with many unaware that what they go through is a serious human rights violation as well as criminal in nature.

The study calls for renewed efforts to improve the expectant mother-healthcare giver relationship.

While it praises efforts to improve the facilities by the government, and increased investment by private individuals, it suggests that the “soft tissues” during labour and delivery, which can be described as “a vulnerable moment” during the birthing needs to be documented.

It says that at least 100 women underwent Caesarean Section procedures, with a small percentage of 4.3per cent reporting non-consented care where they were subjected to tubal ligation and heteroscopy.