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Nepalese nursing students’ experiences of witnessing disrespectful and abusive care towards women during labour and childbirth

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      Background

      There are increasing reports of disrespectful and abusive care towards women in health facilities during labour and birth which contributes to low uptake of facility-based childbirth in low- and middle-income countries.

      Aim

      To investigate undergraduate nursing students’ witnessing of disrespect and abuse towards women during their midwifery clinical practicum.

      Methods

      A cross-sectional study was conducted with nursing students (n = 268) in two medical colleges in Nepal. The survey instrument consisted of sociodemographic variables, clinical placement variables, students’ perceptions of respectful maternity care, and nine forms of disrespectful and abusive care practices that may have been observed during their clinical practicum.

      Findings

      A total of 171 students (63.8%) students participated. Students’ mean age was 23.68 (SD = 2.44, range = 20-34). Almost half (48%) were in the third year of their program. A total of 138 (80.7%) students had witnessed at least one form of disrespectful and abusive care. Students observed other people not involved in a woman’s care to being present at the birth (43.9%), treating women in an unfriendly manner (42.7%), verbal abuse such as shouting, scolding, insulting, or threatening (33.9%), talking about a woman’s health information with others not directly involved in her care (33.9%), discrimination (24.6%), leaving women exposed (23.4%), and physical abuse such as pushing, slapping, or pinching women if they did not co-operate (23.4%).

      Conclusions

      Witnessing disrespectful and abusive care may adversely impact students’ provision of respectful maternity care (RMC). Educating students about the status of women; midwifery philosophy of care; and strategies to navigate and change a medically-dominated model of care are required. Identification of organisational and personal factors associated with disrespect and abuse is necessary to develop and implement tailored interventions to enhance RMC.
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