Table 2 Types of harsh or abusive behavior preceding, during or after childbirth as defined by mothers, fathers, CHWs and leaders
Feeling Ignored, Neglected or Mistreated | Mother | Father | CHW | Leader | |
|---|---|---|---|---|---|
Family feared delivering alone | X | X | X | ||
Delivery began or completed in absence of any provider or helper | X | X | X | X | |
Women felt ignored post delivery (no counseling, no help bathing, walking, removing soiled clothes) | X | ||||
Provider turned family away; told to find a local TBA | X | ||||
Provider routinely absent | X | ||||
Provider routinely ignores women (“they told me I should not interrupt their lunch”) | X | X | X | X | |
Provider refused to wake for a night delivery | X | X | X | X | |
Provider had no time to explain a concern | X | X | X | ||
Provider told woman to clean delivery room, mattress and/or table on which a woman delivered | X | ||||
Provider delayed referral until it becomes dangerous for mother or difficult for a family to travel | X | ||||
Provider demonstrated favoritism (toward those who are “connected”) | X | X | X | ||
Provider said “there’s nothing to do” during a complicated delivery (belated referral for c-section) | X | ||||
Unpredictable Financial Demands/Concerns About Money | Mother | Father | CHW | Leader | |
Feeling overcharged (see others pay less or paid less previously); bothered by inconsistent pricing | X | X | X | ||
Being charged a fine for delivering at home | X | ||||
Being forced to wait longer while those with more money are seen first | X | X | |||
Being charged for a child’s clinic card | X | X | |||
Feeling pressured or coerced to pay a bribe (“facility entrance fee” “bed charge” “recognition fee”) | X | X | |||
Being required to pay for medicines bought from a nearby pharmacy or from a nurse (referred to as “going the illegal way” ukaenda ukapita njia or “doing business” kufanya kama biashara) | X | X | X | X | |
Verbal Abuse | Mother | Father | CHW | Leader | |
Reports of “being shouted at” or “scolded” for: | X | X | X | X | |
● Being too tired; “not pushing hard enough” | ● Having a TBA as an escort to a facility | ||||
● Having too many children; “ruining” one’s body | ● Making a special case of oneself or “requesting too much attention” | ||||
● Arriving too early or too late during labor | |||||
● Taking traditional herbs | ● Delivering at home in the past | ||||
● Seeking or heeding advice from a TBA | ● Delivering at home and then bringing baby to be registered | ||||
● Wearing old or dirty clothes | |||||
Physical Abuse | Mother | Father | CHW | Leader | |
A nurse refuses to remove a drip because a woman is complaining too much | X | ||||
A nurse slaps a delivering woman | X | ||||
A nurse forces a woman to deliver in a “bad” position (“like kneeling with my head down”) | X | ||||