White Ribbon Alliance India study flags expecting women’s woes in Punjab
THE TRIBUNE, INDIA
By Aditi Tandon
Women face physical abuse, neglect during childbearing at public health utilities
New Delhi – Punjab’s women routinely face abuse and neglect during the course of delivery, adversely impacting their pregnancy outcome, as per a study conducted by The White Ribbon Alliance, a group that focuses on respectful maternal care (RMC), in collaboration with the PGI, Chandigarh.
The study was aimed at gauging the level of care provided to pregnant women in the state’s public health facilities.
“Failure to provide comfort to clients, ignoring their calls for help, not responding to their expressions of pain, leaving women unattended in labour rooms and letting family members perform roles of health staff were some of the main manifestations of abandonment or denial found,” the study observed.
Evidence of physical abuse was detected in around 80 per cent of the cases studied.
“Strenuous pressure on the abdomen during delivery and physical handling were most commonly observed. Denial of birth companion in the second or third stage of labour and lack of information about care being provided were also the most commonly identified forms of disrespect and abuse, concluded the study, which the group will now use to seek national-level guidelines on RMC, an emerging concept.
The research documents the experiences of women in childbearing. A patient, Sukhjeet, told investigators, “During the delivery, I was desperate to hold someone’s hand. When you are holding someone’s hand you feel relaxed and that feeling is all I wanted at the time. But the nurse pulled her hand away and told me not to hold it because it was hurting.”
The investigators also found at least one form of non-dignified care in 90 per cent of the childbirth observations in Punjab’s health facilities.
“In most of the narrated cases, the expressions of non-dignified care were rough treatment, display of impatience, passing rude and harsh comments, judgmental comments, treating the patient as a passive participant, and blaming,” says the study, which records a few instances where nurses refused to hand over the newborn unless money was paid to them.
Global evidence suggests mistreatment during childbirth is a barrier to women seeking institutional care and also hampers pregnancy outcomes. Lack of care during childbearing has now been identified by the World Health Organisation (WHO) as a challenge area.
The study makes a case for RMC, saying despite a rapid decline in the maternal mortality rate (MMR) in the past 10 years, 15 per cent of maternal deaths around the world occur in India.
India’s MMR is an estimated 167 deaths per 100,000 live births (SRS 2013). With around 45,000 women dying each year from pregnancy-related causes, India has among the highest number of maternal deaths in the world. This makes the formalisation of RMC critical, argues the study called ‘Respectful Maternal Care in Punjab: A Qualitative Study for Advocacy’.
80% cases studied in Punjab in which evidence of physical abuse found
15% of maternal deaths around the world occur in India
167 deaths per 1,00,000 live births, India’s maternal mortality rate