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

In rural Bangladesh, despite efforts to improve maternal healthcare, women still face mistreatment during childbirth, which can affect their satisfaction with care. This study aims to investigate the prevalence of disrespect and abuse (D&A) during facility-based childbirth, explore its impact on women's satisfaction, and identify key factors that influence these experiences, to inform strategies for improving maternal care.

This facility-based cross-sectional study was conducted at four community clinics in rural Rajshahi, Bangladesh. The study included 400 women who gave birth in designated healthcare facilities and were preparing to leave for a postpartum room. D&A care was defined using six categories: physical abuse, non-confidential care, non-consented care, non-dignified care, invasion of privacy, and abandonment. Maternal satisfaction outcomes included satisfaction with care received and willingness to recommend the facility to others.

25.8% of women received D&A care. According to multivariate logistic regression analysis, mothers who gave birth at night or without the presence of birth companions, mothers who had a vaginal birth or did not receive four or more ANC visits, mothers in the poorest wealth bands, and mothers who had assisted births other than by medical professionals were more likely to report D&A care than their counterparts. There was a higher likelihood of satisfaction (adjusted odds ratio [AOR]: 3.35; 95% CI: 2.81 to 5.81) and of recommending the facility to others (AOR: 2.74; 95% CI: 1.95 to 4.23) among women who reported not having D&A experiences.

D&A care is highly prevalent in primary healthcare settings in rural Bangladesh. The significant contributing factors identified in this study should be addressed to reduce the occurrence of D&A care.