Prevalence of Abuse during Childbirth in an Urbanized Village of Delhi: A Mixed-Method Study

Despite reduced maternity mortality rates in India, the quality of maternal healthcare during childbirth remains underexplored. This study aimed to determine the prevalence and factors associated with abuse during childbirth in East Delhi and to explore community perceptions related to this.

A mixed-method study was conducted from September 2022 to February 2024, involving quantitative surveys of 204 postnatal women and qualitative in-depth interviews with community stakeholders such as ASHA workers, ANMs, and medical practitioners.

Quantitative findings revealed that 58.82% of women experienced some form of abuse during childbirth, with 42.60% facing verbal abuse and 40.70% encountering physical abuse. Key predictors of abuse included delivering at government health facilities, unknown delivery personnel, and type of delivery, with a higher prevalence of abuse during normal vaginal deliveries compared to Caesarean sections. Logistic regression identified the type of healthcare facility (adjusted odd's ratio = 4.220 (95% CI = 1.306-13.635)) as an independent predictor of abuse. Qualitative findings showed that abuse during childbirth is often normalized within the community, with women and stakeholders viewing it as a routine part of the process. Many women attributed the abuse to their characteristics, such as illiteracy and poverty, and rationalized it as necessary for their and their babies' well-being. Community stakeholders noted that abuse is more prevalent in government hospitals due to higher patient loads and overworked staff.

The study highlights the need for targeted interventions to improve the quality of maternal care. This includes training healthcare providers in Respectful Maternity Care, effectively implementing government initiatives like LaQshya and SUMAN, and raising awareness about the rights of pregnant women. Addressing these issues is crucial to ensuring that childbirth experiences are safe, dignified, and respectful, ultimately encouraging more women to seek institutional deliveries.