Women’s Experiences With Maternity Care in Public and Private Healthcare Facilities in Western India: A Community-Based Cross-Sectional Study

TL;DR

This study explores how women in Western India experience maternity care in public and private facilities, revealing widespread disrespectful treatment and suggesting ways to improve care.

Contribution

The study provides new insights into disrespectful maternity care in Western India and identifies sociodemographic factors linked to poor experiences.

Findings

97% of women experienced at least one form of disrespectful care during childbirth.

Low maternal literacy, lower caste, and longer facility stays were significantly associated with RMC violations.

Provider training and system-level support are recommended to improve respectful maternity care.

Abstract

Introduction: Quality improvement interventions for maternal healthcare services are often designed without input from women. Exploring women's childbirth experiences provides a unique understanding of care received in healthcare facilities. This study aimed to investigate women's childbirth experiences in Western India, with an objective to inform the development of woman-centered quality improvement interventions.

Methods: Data were collected from 186 postnatal women who delivered their babies at public or private healthcare facilities. A standardized tool, adapted from the respectful maternity care (RMC) charter, was used to assess women's experiences of care during childbirth.

Results: A high prevalence of disrespectful intrapartum care was observed. Ninety-seven percent of women reported experiencing at least one form of disrespect, with 61% experiencing three or more rights violations and 28% experiencing four or five violations. The study found that factors such as low maternal literacy (χ²=10.75, p<0.05), lower caste (χ²=10.19, p<0.05), and longer duration of stay at the health facility (χ²=8.30, p<0.05) were significantly associated with an increased risk of experiencing RMC violations. Other factors found to be statistically significant included marital status (χ²=5.35, p<0.05) and parity (χ²=6.67, p<0.05).

Conclusion: The study emphasizes the critical need for a multi-pronged approach to improve maternal healthcare in India. To ensure respectful and high-quality maternity care, possible measures include provider training to enhance competencies to be more responsive to women's needs, encouraging effective communication, strengthening system-level support, and empowering women to voice their needs during childbirth. Prospective research to understand local contextual elements, societal norms, and patient-provider communication would be valuable.