The Giving Voice to Mothers study: inequity and mistreatment during pregnancy and childbirth in the United States
Tóm tắt
Recently WHO researchers described seven dimensions of mistreatment in maternity care that have adverse impacts on quality and safety. Applying the WHO framework for quality care, service users partnered with NGOs, clinicians, and researchers, to design and conduct the Giving Voice to Mothers (GVtM)–US study. Our multi-stakeholder team distributed an online cross-sectional survey to capture lived experiences of maternity care in diverse populations. Patient-designed items included indicators of verbal and physical abuse, autonomy, discrimination, failure to meet professional standards of care, poor rapport with providers, and poor conditions in the health system. We quantified the prevalence of mistreatment by race, socio-demographics, mode of birth, place of birth, and context of care, and describe the intersectional relationships between these variables. Of eligible participants (n = 2700), 2138 completed all sections of the survey. One in six women (17.3%) reported experiencing one or more types of mistreatment such as: loss of autonomy; being shouted at, scolded, or threatened; and being ignored, refused, or receiving no response to requests for help. Context of care (e.g. mode of birth; transfer; difference of opinion) correlated with increased reports of mistreatment. Experiences of mistreatment differed significantly by place of birth: 5.1% of women who gave birth at home versus 28.1% of women who gave birth at the hospital. Factors associated with a lower likelihood of mistreatment included having a vaginal birth, a community birth, a midwife, and being white, multiparous, and older than 30 years. Rates of mistreatment for women of colour were consistently higher even when examining interactions between race and other maternal characteristics. For example, 27.2% of women of colour with low SES reported any mistreatment versus 18.7% of white women with low SES. Regardless of maternal race, having a partner who was Black also increased reported mistreatment. This is the first study to use indicators developed by service users to describe mistreatment in childbirth in the US. Our findings suggest that mistreatment is experienced more frequently by women of colour, when birth occurs in hospitals, and among those with social, economic or health challenges. Mistreatment is exacerbated by unexpected obstetric interventions, and by patient-provider disagreements.
Tài liệu tham khảo
Miller S, Abalos E, Chamillard M, Ciapponi A, Colaci D, Comandé D, et al. Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. Lancet. 2016;388:2176–92.
World Health Organization (WHO). Standards for improving quality of maternal and newborn Care in Health Facilities [Internet]. 2016. Available from: http://www.who.int/maternal_child_adolescent/documents/improving-maternal-newborn-care-quality/en/
The Partnership for Maternal Newborn & child health. Professional associations affirm commitment to improving quality of maternal and newborn health care [Internet]. FIGO news, WHO news. 2017. Available from: http://www.who.int/pmnch/media/events/2017/lilongwe/en/index1.html
Reed R, Sharman R, Inglis C. Women’s descriptions of childbirth trauma relating to care provider actions and interactions. BMC Pregnancy Childbirth. 2017;17(1).
Hameed W, Avan BI. Women’s experiences of mistreatment during childbirth: a comparative view of home- and facility-based births in Pakistan. PLoS One. 2018;13(3):e0194601.
McMahon S, George A, Chebet J, Mosha I, Mpembeni R, Winch P. Experiences of and responses to disrespectful maternity care and abuse during childbirth; a qualitative study with women and men in Morogoro region, Tanzania. BMC Pregnancy Childbirth. 2014;14(1):268.
Baker S, Choi P, Henshaw C. ‘I Felt as though I’d been in Jail’: Women’s Experiences of Maternity Care during Labour, Delivery and the Immediate Postpartum. Feminism & Psychology. 2005;15(3):315–42.
Kane S, Rial M, Kok M, Matere A, Dieleman M, Broerse JEW. Too afraid to go: fears of dignity violations as reasons for non-use of maternal health services in South Sudan. Reprod Health. 2018;15(1).
Khosla R, Zampas C, Vogel JP, Bohren MA, Roseman M, Erdman JN. International human rights and the mistreatment of women during childbirth. Health Hum Rights. 2016;18(2):131.
Freedman LP, Kruk ME. Disrespect and abuse of women in childbirth: challenging the global quality and accountability agendas. Lancet. 2014;384(9948):e42–4.
World Health Organization (WHO). Prevention and elimination of disrespect and abuse during facility-based childbirth [internet]. Geneva, Switzerland: WHO Statement; 2015 [cited 2016 Apr 4]. Available from: https://apps.who.int/iris/bitstream/handle/10665/134588/WHO_RHR_14.23_eng.pdf;jsessionid=5EAC99EB257C701EF9FC086FD19D5FE7?sequence=1
Rosenthal L, Lobel M. Explaining racial disparities in adverse birth outcomes: unique sources of stress for black American women. Soc Sci Med. 2011;72(6):977–83.
Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. PLoS Med [Internet]. 2015 [cited 2016 Mar 22];12(6):e1001847; discussion e1001847. Available from: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001847
Warren CE, Njue R, Ndwiga C, Abuya T. Manifestations and drivers of mistreatment of women during childbirth in Kenya: implications for measurement and developing interventions. BMC Pregnancy and Childbirth. 2017;17(1):102.
Beck CT. A secondary analysis of mistreatment of women during childbirth in health care facilities. J Obstet Gynecol Neonatal Nurs. 2018;47(1).
Ravaldi C, Skoko E, Battisti A, Cericco M, Vannacci A. Abuse and disrespect in childbirth assistance in Italy: a community-based survey. Eur J Obstet Gynecol Reprod Biol. 2018;224:208–9.
Babiaková K, Debrecéniová J, Hlinčíková M, Krišková Z, Sekulová M, Šumšalová S. Women mothers bodies: women’s human rights in obstetric care in healthcare facilities in Slovakia. Občan, demokracia a zodpovednosť. 2015.
Howell EA, Zeitlin J. Quality of care and disparities in obstetrics. Obstet Gynecol Clin N Am. 2017;44(1):13-25.
Abuya T, Ndwiga C, Ritter J, Kanya L, Bellows B, Binkin N, et al. The effect of a multi-component intervention on disrespect and abuse during childbirth in Kenya. BMC Pregnancy and Childbirth. 2015;15(1).
Elder TE, Goddeeris JH, Haider SJ. Racial and ethnic infant mortality gaps and the role of socio-economic status. Labour Econ. 2016;43:42–54.
Watson HL, Downe S. Discrimination against childbearing Romani women in maternity care in Europe: a mixed-methods systematic review. Reprod Health. 2017;14(1).
McRae DN, Janssen PA, Vedam S, Mayhew M, Mpofu D, Teucher U, et al. Reduced prevalence of small-for-gestational-age and preterm birth for women of low socioeconomic position: a population-based cohort study comparing antenatal midwifery and physician models of care. BMJ Open. 2018;8(10):e022220.
Declercq ER, Sakala C, Corry MP, Applebaum S, Herrlich A. Major survey findings of listening to mothers (SM) III: new mothers speak out. J Perinat Educ. 2014;23(1):17–24.
Bond S, You X. Mistreatment of women during pregnancy and birth impedes global efforts to improve access, quality, and safety of maternity care. J Midwifery Womens Health. 2015;60(6):785.
DeVoe JE, Wallace LS, Fryer GE. Measuring patients’ perceptions of communication with healthcare providers: do differences in demographic and socioeconomic characteristics matter? Health Expect. 2009;12(1):70–80.
Downe S, Finlayson K, Tuncalp O, Metin Gülmezoglu A. What matters to women: a systematic scoping review to identify the processes and outcomes of antenatal care provision that are important to healthy pregnant women. BJOG An Int J Obstet Gynaecol. 2016;123(4):529–39.
Freedman LP, Ramsey K, Abuya T, Bellows B, Ndwiga C, Warren CE, et al. Defining disrespect and abuse of women in childbirth: a research, policy and rights agenda. Bull World Health Organ. 2014;92(12):915–7.
Bowleg L. The problem with the phrase women and minorities: intersectionality-an important theoretical framework for public health. Am J Public Health. 2012;102((7):1267–73.
Horowitz CR, Robinson M, Seifer S. Community-based participatory research from the margin to the mainstream. Circulation. 2009;119(19):2633–42.
Israel BA. Methods for community-based participatory research for health. San Francisco, CA: Jossey-Bass; 2013. p3-37.
Vedam S, Stoll K, Martin K, Rubashkin N, Partridge S, Thordarson D, et al. The Mother’s autonomy in decision making (MADM) scale: patient-led development and psychometric testing of a new instrument to evaluate experience of maternity care. Kumar S, editor. PLoS One [Internet]. 2017 [cited 2017 Aug 14];12(2):e0171804. Available from: http://dx.plos.org/10.1371/journal.pone.0171804
Vedam S, Stoll K, Rubashkin N, Martin K, Miller-Vedam Z, Hayes-Klein H, et al. The Mothers on Respect (MOR) index: measuring quality, safety, and human rights in childbirth. SSM - Popul Heal [Internet]. 2017 Dec [cited 2017 Aug 14];3:201–210. Available from: http://linkinghub.elsevier.com/retrieve/pii/S2352827317300174.
Mortel M, Mehta SD. Systematic Review of the Efficacy of Herbal Galactogogues. J Hum Lact. 2013;29(2):154–62.
Green NL. Development of the perceptions of racism scale. J Nurs Scholarsh. 1995;27(2):141–6.
Kruk ME, Kujawski S, Mbaruku G, Ramsey K, Moyo W, Freedman LP. Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey. Health Policy Plan. 2018;33(1):e26–33.
Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489-97.
Bonevski B, Randell M, Paul C, Chapman K, Twyman L, Bryant J, et al. Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups. BMC Med Res Methodol. 2014;14:1–29.
Merli MG, Verdery A, Mouw T, Li J. Sampling migrants from their social networks: the demography and social organization of Chinese migrants in Dar Es Salaam, Tanzania. Migr Stud. 2016;4(2):182–214.
Schicker RS, Hiruy N, Melak B, Gelaye W, Bezabih B, Stephenson R, et al. A venue-based survey of malaria, anemia and mobility patterns among migrant farm workers in Amhara region, Ethiopia. PLoS One. 2015;10(11):e0143829.
Cheyney M, Bovbjerg M, Everson C, Gordon W, Hannibal D, Vedam S. Development and validation of a national data registry for midwife-led births: the midwives alliance of North America statistics project 2.0 dataset. J Midwifery Women’s Heal. 2014;59(1):8–16.
MacDorman MF, Declercq E. Trends and characteristics of United States out-of-hospital births 2004-2014: new information on risk status and access to care. Birth. 2016;43(2):116–124.
A roadmap for promoting health equity and eliminating disparities: the four I’s for health equity: final report [Internet]. A roadmap for promoting health equity and eliminating disparities: the four I’s for health equity: final report. National Quality Forum; 2017 Sep. Available from: https://www.qualityforum.org/Publications/2017/09/A_Roadmap_for_Promoting_Health_Equity_and_Eliminating_Disparities__The_Four_I_s_for_Health_Equity.aspx.
McLemore MR, Altman MR, Cooper N, Williams S, Rand L, Franck L. Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth. Soc Sci Med. 2018;201:127–35.
The Joint Commission. Implicit bias in health care. Quick Saf. 2016.
Bryant AS, Worjoloh A, Caughey AB, Washington AE. Racial/ethnic disparities in obstetric outcomes and care: prevalence and determinants. Am J Obstet Gynecol. 2010;202(4):335–43.
Krieger N, Gruskin S, Singh N, Kiang MV, Chen JT, Waterman PD, et al. Reproductive justice & preventable deaths: state funding, family planning, abortion, and infant mortality, US 1980-2010. SSM - Popul Heal. 2016;2:277–93.
Wong CA, Gachupin FC, Holman RC, Macdorman MF, Cheek JE, Holve S, et al. American Indian and Alaska native infant and pediatric mortality, United States, 1999-2009. Am J Public Health. 2014;104(S3).
Vedam S, Stoll K, MacDorman M, Declercq E, Cramer R, Cheyney M, et al. Mapping integration of midwives across the United States: impact on access, equity, and outcomes. PLoS One. 2018;13(2):e0192523.
Ceron A, Ruano AL, Sanchez S, Chew AS, Diaz D, Hernandez A, et al. Abuse and discrimination towards indigenous people in public health care facilities: experiences from rural Guatemala. Int J Equity Health. 2016;15(1):77.
Varcoe C, Brown H, Calam B, Harvey T, Tallio M. Help bring back the celebration of life: a community-based participatory study of rural aboriginal women’s maternity experiences and outcomes. BMC Pregnancy Childbirth 2013;13(1):26. Available here: https://doi.org/10.1186/1471-2393-13-26
Morris T, Schulman M. Race inequality in epidural use and regional anesthesia failure in labor and birth: an examination of women’s experience. Sex Reprod Healthc. 2014;5(4):188–94.
Min CJ, Ehrenthal DB, Strobino DM. Investigating racial differences in risk factors for primary cesarean delivery. Am J Obstet Gynecol. 2015;212(6).
Huesch M, Doctor JN. Factors Associated With Increased Cesarean Risk Among African American Women: Evidence From California, 2010. American Journal of Public Health. 2015;105(5):956–62.
Washington S, Caughey AB, Cheng YW, Bryant AS. Racial and ethnic differences in indication for primary cesarean delivery at term: experience at one U.S. institution. Birth. 2012;39(2):128–34.
Yee LM, Costantine MM, Rice MM, Bailit J, Reddy UM, Wapner RJ, et al. Racial and ethnic differences in utilization of labor management strategies intended to reduce cesarean delivery rates. Obstet Gynecol. 2017;130(6):1285–94.
Morris T, Meredith O, Schulman M, Morton CH. Race, insurance status, and nulliparous, term, singleton, vertex cesarean indication: a case study of a New England tertiary hospital. Women’s Heal Issues. 2016;26(3):329-335.
California Maternal Quality Care Collaborative. California Pregnancy-Associated Mortality Review (CA-PAMR): Report from 2002 and 2007 Maternal death reviews [internet]. 2018. Available from: https://www.cmqcc.org/resource/california-pregnancy-associated-mortality-review-ca-pamr-report-2002-and-2007-maternal
Cheyney M, Everson C, Burcher P. Homebirth transfers in the United States: narratives of risk, fear, and mutual accommodation. Qual Health Res. 2014;24(2):443–56.
Amnesty International. Deadly Delivery The Maternal Health Care Crisis in the USA. 2011[cited 2017 Apr 3]; Available from: http://www.amnestyusa.org/sites/default/files/deadlydeliveryoneyear.pdf.
Vogel JP, Bohren MA, Tunçalp O, Oladapo OT, Gülmezoglu AM. Promoting respect and preventing mistreatment during childbirth. BJOG. 2016;123(5):671–4.
Anderson AC, O’Rourke E, Chin MH, Ponce NA, Bernheim SM, Burstin H. Promoting health equity and eliminating disparities through performance measurement and payment. Health Aff. 2018;37(3):371–7.
Martin, Joyce A. MPH, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births : final data for 2017 [internet]. National Vital Statistics Reports. CDC; 2018 [cited 2018 Dec 15]. Available from: https://stacks.cdc.gov/view/cdc/60432.
Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. Jewkes R, editor. PLoS Med [Internet]. 2015 [cited 2017 Sep 3];12(6):e1001847. Available from: http://dx.plos.org/10.1371/journal.pmed.1001847.