Forms of support and experiencing maltreatment and disrespect during childbirth at a health facility: a self-reported cross-sectional study in Ghana

Providing support to women and encouraging women to deliver in health facility settings (skilled delivery) is one strategy to improve maternal health outcomes in developing countries. However, fear of maltreatment and disrespect during labour and delivery, have been reported as barriers to facility delivery. This study was therefore conducted to assess postnatal women’s self-reported experience and type of maltreatment and disrespect during delivery. Using a cross sectional study design, 313 women were randomly selected from the three health facilities located in the La-Nkwantenang-Madina Municipality in the Greater Accra region. The data was analysed using STATA 15. Bivariable data analysis using Pearson’s Chi-square was used to determine the association between socio-demographic characteristics, reproductive history and experience of maltreatment. Logistic regression analysis was done to determine the strengths of association. More than half (54.3%) of the postnatal women were encouraged to have support persons during labour and delivery. About 75.7% reported experiencing some form of maltreatment and disrespect. About a fifth (19.8%, n=62) of the women experienced physical abuse, 9.3% (n=29) experienced undignified care, 7.7% (n=24) of the women were detained or confined against their will, and 60.4% (n=189) indicated they did not receive consented care. The study concludes that maltreatment and disrespect during labour is widespread. Expanding health facilities may not achieve desired skilled or facility-based delivery without improving the birth experience of women.