Burrowes S, et al. – A qualitative study is carried out to investigate the experiences of disrespect and abuse in maternal care from the perspectives of both providers and patients. These outcomes propose that training on respectful care, offered in the professional ethics modules of the national midwifery curriculum, ought to be strengthened to include a greater concentration on counseling skills and rapport–building. These outcomes also show that addressing structural issues around provider workload should complement all interventions to improve midwives' interpersonal interactions with women if Ethiopia is to increase provision of respectful, patient–centered maternity care.

Methods

• For this study, they conducted 45 in–depth interviews at four health facilities in Debre Markos, Ethiopia.
• Midwives, midwifery students, and women who had given birth within the past year took part in this study.
• In this study, students and providers also took a brief quantitative survey on patients’ rights amid labor and delivery and responded to clinical scenarios in regards to the provision of stigmatized reproductive health services.

Results

• They find that both health care providers and patients report frequent physical and verbal abuse as well as non–consented care amid labor and delivery.
• Providers report that most abuse is unintended and results from weaknesses in the health system or from medical necessity.
• They revealed no evidence of more systematic types of abuse involving detention of patients, bribery, abandonment or ongoing discrimination against particular ethnic groups.
• Although health care providers demonstrated good basic knowledge of confidentiality, privacy, and consent, training on the principles of responsive and respectful care, and on counseling, is largely absent.
• Providers demonstrated that they would welcome related practical instruction.
• Patient responses propose that women are aware that their rights are being violated and avoid facilities with reputations for poor care.