Disrespect, Abuse, and Satisfaction With Facility-Based Childbirth in Rural Bangladesh.

Area of Science:

• Maternal Health
• Public Health
• Healthcare Quality

Background:

• Despite improvements, women in rural Bangladesh experience mistreatment during childbirth.
• This mistreatment, termed disrespect and abuse (D&A), negatively impacts maternal satisfaction with care.

Purpose of the Study:

• To determine the prevalence of D&A during facility-based childbirth in rural Bangladesh.
• To explore the impact of D&A on women's satisfaction with maternal healthcare.
• To identify factors contributing to D&A experiences to inform care improvement strategies.

Main Methods:

• A cross-sectional study involving 400 women in four rural Bangladeshi community clinics.
• D&A was categorized into six types: physical abuse, non-confidential care, non-consented care, non-dignified care, invasion of privacy, and abandonment.
• Maternal satisfaction was assessed by satisfaction with care and willingness to recommend the facility.

Main Results:

• 25.8% of women reported experiencing D&A during childbirth.
• Factors associated with higher D&A prevalence included nighttime births, absence of birth companions, vaginal birth, fewer than four antenatal care visits, lower socioeconomic status, and non-professional assistance during birth.
• Women without D&A experiences showed significantly higher satisfaction (AOR: 3.35) and willingness to recommend facilities (AOR: 2.74).

Conclusions:

• Disrespect and abuse are highly prevalent in rural Bangladeshi primary healthcare settings.
• Key contributing factors identified in this study must be addressed to mitigate D&A.
• Reducing D&A is crucial for enhancing maternal satisfaction and improving the quality of maternal healthcare.