Disrespectful and abusive practices in intrapartum hospital care during the pandemic: a systematic review

Abstract

Abstract Objective: Decent maternal care, the provision of quality obstetric practices, childbirth with dignity and with respect for the rights of the woman on the spot are situations that are threatened every day. A systematic review was conducted with the aim of investigating how the Covid-19 pandemic has affected the quality of maternity care and whether there has been an increase in ungodly and abusive practices in childbirth. Material and methods: We searched for peer-reviewed articles published in English and Greek language in five online databases, Medline/ PubMed, Cochrane, Science Direct and Scholar, using the following keywords: “substandard care”, “abusive behavior”, “during labor”, “disrespectful intrapartum care”, “pandemic”, “COVID 19”. Articles were selected based on five inclusion criteria: (a) studies published since December 2019; (b) primary studies; (c) studies in English and Greek language; (d) quantitative and/or qualitative as a methodological approach and (e) with a sample of patients who gave birth in hospitals and/or midwives/obstetricians who worked in hospital delivery rooms during the pandemic. Results: The total number of studies is 275. 131 via NCBI; 25 via Cochrane; 56 via Google Scholar and 63 via Science Direct. From all those studies only 14 articles were found to meet all inclusion criteria. A systematic analysis of fourteen studies mainly showed that (a) the partners were removed from the women; (b) women felt alone, helpless and isolated; (c) insufficient communication of the staff with the women; (d) lack of guidance and counseling; (e) women did not provide consent for obstetric practices; and (f) they are not informed about the actions that were taking place. Conclusion:It is crucial to note that disrespectful practices, i.e. emotional and verbal violence, disrespectful and abusive practices applied during childbirth are constantly observed in everyday obstetric practice, especially in countries with low socioeconomic status. Women experience unpleasant feelings which in COVID 19 times increased rapidly creating challenges for the health system. Keywords substandard care, abusive behavior during labor, disrespectful intrapartum care, pandemic, COVID-19