A global study of over two thousand women in four countries found that 41 percent of respondents “experienced physical or verbal abuse, or stigma or discrimination” during childbirth.
The study, published by the Lancet, included surveys and labor observations of 2,672 pregnant people at 12 different health facilities located in urban areas in Ghana, Guinea, Myanmar, and Nigeria between September 19, 2016, and January 18, 2018. The study found physical and verbal abuse of those in labor usually peaked from about 30 minutes before birth at lasted until about 15 minutes after. Healthcare workers reportedly pinched patients, forced episiotomies and c-sections, and verbally humiliated people in the process of giving birth, but respondents most frequently reported being slapped:
“The most common physical abuse is slapping the thighs, especially when women try to close their thighs at the time of delivery,” an author of the study, Dr. Ernest Maya told NPR in an e-mail interview.
The study included pregnant people aged 15 to 35. Of these, 87 percent were married, while 10 percent were single. According to NPR, those who were single were much more likely to report verbal humiliation:
“One of [the] things we found is that when adolescent girls are using maternity services, some providers are making judgments about their sexuality, the study’s lead author, Meghan Bohren, of the School of Population and Global Health at the University of Melbourne in Australia told NPR.
“A common report we hear is of providers saying something like, ‘Were you yelling like that when you made this baby?’” added Cheryl Moyer, associate professor at the University of Michigan, who wrote commentary for the study in the Lancet.
Until recently, most studies simply focused on maternal survival rates without regard to the quality of care pregnant people received as long as they did not die. But in 2010, Diana Bowser and Dr. Kathleen Hill released a report called “Exploring Evidence for Disrespect and Abuse” for the U.S. Agency for International Development, which reviewed over 150 documents from medical journals, international health surveys, and legislation from around the world and interviewed those who had experienced abuse during labor. The report was one of the first to broach the subject of physical and verbal abuse of pregnant people by healthcare workers on a global scale:
“Bowser and Hill reported evidence of health-care providers humiliating women in 150 studies covering 18 different countries, most low- and middle-income but including the U.S. and Canada. Reports from the U.S included such things as women saying they were coerced into having a Cesarean section, and women reporting racism and discrimination. The report also noted a Human Rights Watch report saying that pregnant women have died while being detained in U.S. immigration facilities.”
The authors of the more recent study hope that their findings will not only “bring consistency to the measurement of abuse of pregnant women” but further the conversation begun by Bowser and Hill about how best to train health-care workers around issues of consent and privacy.