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Background: Women across the world are mistreated during childbirth. We aimed to develop and implement evidence-informed, validated tools to measure mistreatment during childbirth, and report results from a cross-sectional study in four low-income and middle-income countries. Methods: We prospectively recruited women aged at least 15 years in twelve health facilities three per country in Ghana, Guinea, Myanmar, and Nigeria between Sept 19, , and Jan 18, Continuous observations of labour and childbirth were done from admission up to 2 h post partum.
Surveys were administered by interviewers in the community to women up to 8 weeks post partum. Labour observations were not done in Myanmar. Data were collected on sociodemographics, obstetric history, and experiences of mistreatment.
Findings: labour observations and surveys were done. Physical and verbal abuse peaked 30 min before birth until 15 min after birth observation. Younger age years and lack of education were the primary determinants of mistreatment survey. Interpretation: More than a third of women experienced mistreatment and were particularly vulnerable around the time of birth. Women who were younger and less educated were most at risk, suggesting inequalities in how women are treated during childbirth.
Understanding drivers and structural dimensions of mistreatment, including gender and social inequalities, is essential to ensure that interventions adequately account for the broader context. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL. Abstract Background: Women across the world are mistreated during childbirth.
