# 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.

## Key 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.