Midwives’ perspectives on (dis)respectful intrapartum care during facility-based delivery in sub-Saharan Africa: a qualitative systematic review and meta-synthesis
Abstract Background In the past decade, the negative impact of disrespectful maternity care on women’s utilisation and experiences of facility-based delivery has been well documented. Less is known about midwives’ perspectives on these labour ward dynamics. Yet efforts to provide care that satisfies...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | Reproductive Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12978-019-0773-y |
| _version_ | 1828386260756987904 |
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| author | Susan Bradley Christine McCourt Juliet Rayment Divya Parmar |
| author_facet | Susan Bradley Christine McCourt Juliet Rayment Divya Parmar |
| author_sort | Susan Bradley |
| collection | DOAJ |
| description | Abstract Background In the past decade, the negative impact of disrespectful maternity care on women’s utilisation and experiences of facility-based delivery has been well documented. Less is known about midwives’ perspectives on these labour ward dynamics. Yet efforts to provide care that satisfies women’s psycho-socio-cultural needs rest on midwives’ capacity and willingness to provide it. We performed a systematic review of the emerging literature documenting midwives’ perspectives to explore the broader drivers of (dis)respectful care during facility-based delivery in the sub-Saharan African context. Methods Seven databases (CINAHL, PsychINFO, PsychArticles, Embase, Global Health, Maternity and Infant Care and PubMed) were systematically searched from 1990 to May 2018. Primary qualitative studies with a substantial focus on the interpersonal aspects of care were eligible if they captured midwives’ voices and perspectives. Study quality was independently assessed by two reviewers and PRISMA guidelines were followed. The results and findings from each study were synthesised using an existing conceptual framework of the drivers of disrespectful care. Results Eleven papers from six countries were included and six main themes were identified. ‘Power and control’ and ‘Maintaining midwives’ status’ reflected midwives’ focus on the micro-level interactions of the mother-midwife dyad. Meso-level drivers of disrespectful care were: the constraints of the ‘Work environment and resources’; concerns about ‘Midwives’ position in the health systems hierarchy’; and the impact of ‘Midwives’ conceptualisations of respectful maternity care’. An emerging theme outlined the ‘Impact on midwives’ of (dis)respectful care. Conclusion We used a theoretically informed conceptual framework to move beyond the micro-level and interrogate the social, cultural and historical factors that underpin (dis)respectful care. Controlling women was a key theme, echoing women’s experiences, but midwives paid less attention to the social inequalities that distress women. The synthesis highlighted midwives’ low status in the health system hierarchy, while organisational cultures of blame and a lack of consideration for them as professionals effectively constitute disrespect and abuse of these health workers. Broader, interdisciplinary perspectives on the wider drivers of midwives’ disrespectful attitudes and behaviours are crucial if efforts to improve the maternity care environment - for women and midwives - are to succeed. |
| first_indexed | 2024-12-10T05:34:08Z |
| format | Article |
| id | doaj.art-d029974dec11455e84df9b995d919c0b |
| institution | Directory Open Access Journal |
| issn | 1742-4755 |
| language | English |
| last_indexed | 2024-12-10T05:34:08Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Health |
| spelling | doaj.art-d029974dec11455e84df9b995d919c0b2022-12-22T02:00:27ZengBMCReproductive Health1742-47552019-07-0116111610.1186/s12978-019-0773-yMidwives’ perspectives on (dis)respectful intrapartum care during facility-based delivery in sub-Saharan Africa: a qualitative systematic review and meta-synthesisSusan Bradley0Christine McCourt1Juliet Rayment2Divya Parmar3School of Health Sciences, City, University of LondonSchool of Health Sciences, City, University of LondonSchool of Health Sciences, City, University of LondonSchool of Health Sciences, City, University of LondonAbstract Background In the past decade, the negative impact of disrespectful maternity care on women’s utilisation and experiences of facility-based delivery has been well documented. Less is known about midwives’ perspectives on these labour ward dynamics. Yet efforts to provide care that satisfies women’s psycho-socio-cultural needs rest on midwives’ capacity and willingness to provide it. We performed a systematic review of the emerging literature documenting midwives’ perspectives to explore the broader drivers of (dis)respectful care during facility-based delivery in the sub-Saharan African context. Methods Seven databases (CINAHL, PsychINFO, PsychArticles, Embase, Global Health, Maternity and Infant Care and PubMed) were systematically searched from 1990 to May 2018. Primary qualitative studies with a substantial focus on the interpersonal aspects of care were eligible if they captured midwives’ voices and perspectives. Study quality was independently assessed by two reviewers and PRISMA guidelines were followed. The results and findings from each study were synthesised using an existing conceptual framework of the drivers of disrespectful care. Results Eleven papers from six countries were included and six main themes were identified. ‘Power and control’ and ‘Maintaining midwives’ status’ reflected midwives’ focus on the micro-level interactions of the mother-midwife dyad. Meso-level drivers of disrespectful care were: the constraints of the ‘Work environment and resources’; concerns about ‘Midwives’ position in the health systems hierarchy’; and the impact of ‘Midwives’ conceptualisations of respectful maternity care’. An emerging theme outlined the ‘Impact on midwives’ of (dis)respectful care. Conclusion We used a theoretically informed conceptual framework to move beyond the micro-level and interrogate the social, cultural and historical factors that underpin (dis)respectful care. Controlling women was a key theme, echoing women’s experiences, but midwives paid less attention to the social inequalities that distress women. The synthesis highlighted midwives’ low status in the health system hierarchy, while organisational cultures of blame and a lack of consideration for them as professionals effectively constitute disrespect and abuse of these health workers. Broader, interdisciplinary perspectives on the wider drivers of midwives’ disrespectful attitudes and behaviours are crucial if efforts to improve the maternity care environment - for women and midwives - are to succeed.http://link.springer.com/article/10.1186/s12978-019-0773-yMidwiferyDisrespect and abuseChildbirthSub-Saharan AfricaRespectful maternity careFacility-based delivery |
| spellingShingle | Susan Bradley Christine McCourt Juliet Rayment Divya Parmar Midwives’ perspectives on (dis)respectful intrapartum care during facility-based delivery in sub-Saharan Africa: a qualitative systematic review and meta-synthesis Reproductive Health Midwifery Disrespect and abuse Childbirth Sub-Saharan Africa Respectful maternity care Facility-based delivery |
| title | Midwives’ perspectives on (dis)respectful intrapartum care during facility-based delivery in sub-Saharan Africa: a qualitative systematic review and meta-synthesis |
| title_full | Midwives’ perspectives on (dis)respectful intrapartum care during facility-based delivery in sub-Saharan Africa: a qualitative systematic review and meta-synthesis |
| title_fullStr | Midwives’ perspectives on (dis)respectful intrapartum care during facility-based delivery in sub-Saharan Africa: a qualitative systematic review and meta-synthesis |
| title_full_unstemmed | Midwives’ perspectives on (dis)respectful intrapartum care during facility-based delivery in sub-Saharan Africa: a qualitative systematic review and meta-synthesis |
| title_short | Midwives’ perspectives on (dis)respectful intrapartum care during facility-based delivery in sub-Saharan Africa: a qualitative systematic review and meta-synthesis |
| title_sort | midwives perspectives on dis respectful intrapartum care during facility based delivery in sub saharan africa a qualitative systematic review and meta synthesis |
| topic | Midwifery Disrespect and abuse Childbirth Sub-Saharan Africa Respectful maternity care Facility-based delivery |
| url | http://link.springer.com/article/10.1186/s12978-019-0773-y |
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