# Childbirth outcomes in rape-related pregnancies: a comparative study of women receiving care in a birthing room designed to promote person-centredness in eastern Democratic Republic of Congo

## TL;DR

Women with rape-related pregnancies had similar childbirth outcomes to others when receiving person-centered care in a specially designed birthing room in eastern DRC.

## Contribution

Demonstrates that person-centered care in a specialized birthing room can lead to comparable childbirth outcomes for women with rape-related pregnancies.

## Key findings

- Women with rape-related pregnancies had 81.8% vaginal births, similar to 83.4% in the comparison group.
- Childbirth experience was positively rated by 80.5% of women with rape-related pregnancies and 84.8% in the comparison group.
- Person-centered care in a specialized birthing room led to comparable outcomes for rape-related pregnancies as for other pregnancies.

## Abstract

There is limited knowledge regarding childbirth outcomes among women with pregnancies resulting from rape. At Panzi Hospital, a tertiary hospital in eastern Democratic Republic of Congo (DRC), a holistic care programme is provided for survivors of sexual violence.

Explore childbirth outcomes among women classified as Robson Group 1 who received care in a birthing room designed to promote person-centredness, comparing those with rape-related pregnancies to other women.

This study was conducted between March 2021 and July 2022, with consecutive collection of childbirth data from nulliparous women at term with a single foetus in cephalic presentation and spontaneous onset of labour, i.e. Robson Group 1. All participants received care in a new birthing room designed to promote person-centredness. Childbirth outcomes were compared between women with rape-related pregnancies (n = 159) and those without (n = 302).

No statistically significant differences in childbirth outcomes were observed. Among women with rape-related pregnancies, 81.8% had vaginal births, compared to 83.4% in the comparison group. Caesarean section rates were 18.2% and 16.6%, respectively. The childbirth experience was rated positively by 80.5% of women in the rape-related pregnancy group and 84.8% in the comparison group with scores of 8–10 on the modified Visual Analogue Scale for Overall Childbirth Experience (VAS-OCE, 0–10).

Childbirth outcomes among women with rape-related pregnancies receiving care within a holistic programme were comparable to those of other pregnant women, when care was provided in a birthing room designed to promote person-centred care.

Main findings: Women with pregnancies resulting from rape, classified as Robson Group 1, receiving care in a birthing room adapted to promote person-centredness, had similar childbirth outcomes compared to other pregnant women in the same classification.Added knowledge: Women classified as Robson 1, whose pregnancies resulted from rape, may have good childbirth outcomes when being cared for in a more personally adapted birthing room and getting continuous perinatal preparation and support.Global health impact for policy and action: Special attention should be put on the care of women with pregnancy due to rape. Holistic care programmes and a person-centred approach may be used also in contexts with limited resources.

Main findings: Women with pregnancies resulting from rape, classified as Robson Group 1, receiving care in a birthing room adapted to promote person-centredness, had similar childbirth outcomes compared to other pregnant women in the same classification.

Added knowledge: Women classified as Robson 1, whose pregnancies resulted from rape, may have good childbirth outcomes when being cared for in a more personally adapted birthing room and getting continuous perinatal preparation and support.

Global health impact for policy and action: Special attention should be put on the care of women with pregnancy due to rape. Holistic care programmes and a person-centred approach may be used also in contexts with limited resources.