Table 4.
Comparison of self-reported and observed mistreatment (N=1536)
| A: Reported, observed | B: Not reported, observed | C: Reported not observed | D: Not reported, not observed | Sensitivity (%, 95% CI) (A/(A+C)) |
Specificity (%, 95% CI) (D/(B+D)) |
% Agreement (A+D)/(N)) |
Inflation factor (IF) (A+B)/(A+C) |
Risk of bias* | |
| Physical and verbal abuse | |||||||||
| Any physical abuse (N=1536) | 83 | 142 | 107 | 1204 | 44 (41 to 46) | 89 (88 to 91) | 84 | 1.18 | Low |
| Any slap, pinch, punch, hit (N=1378) | 46 | 102 | 46 | 1204 | 50 (47 to 53) | 92 (91 to 94) | 89 | 1.61 | Moderate |
| Any forceful downward pressure on abdomen (N=1278) | 22 | 12 | 40 | 1204 | 35 (33 to 38) | 99 (99 to 100) | 96 | 0.55 | Moderate |
| Any verbal abuse (N=1536) | 334 | 269 | 215 | 718 | 61 (58 to 63) | 73 (71 to 75) | 68.5 | 1.10 | Low |
| Any shout, scold, insult, mock, negative comments‡ (N=1435) | 292 | 259 | 166 | 718 | 64 (61 to 66) | 73 (71 to 76) | 70 | 1.20 | Low |
| Any threats or blame† (N=815) | 42 | 10 | 45 | 718 | 48 (46 to 51) | 99 (98 to 99) | 93 | 0.60 | Moderate |
| Stigma or discimination | |||||||||
| Any stigma or discrimination (N=1536) | 2 | 7 | 55 | 1472 | 4 (3-4) | 100 (99 to 100) | 96 | 0.16 | High |
| Failure to meet professional standards of care | |||||||||
| Non-consented care among procedures | |||||||||
| Caesarean section (N=144) | 6 | 20 | 14 | 104 | 30 (28 to 32) | 84 (82 to 86) | 76 | 1.30 | Low |
| Episiotomy§ (N=105) | 44 | 8 | 32 | 21 | 58 (56 to 61) | 72 (70 to 75) | 62 | 0.68 | Moderate |
| Vaginal examinations (N=986) | 377 | 144 | 230 | 235 | 62 (60 to 64) | 62 (60 to 64) | 62 | 0.86 | Low |
| Vaginal examinations— private health information disclosed during examination (N=1057) | 69 | 67 | 115 | 815 | 38 (36 to 39) | 92 (91 to 94) | 83 | 0.74 | Moderate |
| Pain relief requested§ | 50 | 58 | 231 | 1186 | 18 (16 to 20) | 95 (94 to 96) | 81 | 0.38 | High |
| Not received (n=50) | 15 | 4 | 4 | 25 | 79 (77 to 81) | 86 (84 to 88) | 83 | 1.00 | Low |
| No staff member present when baby born§ (n=1519) | 10 | 54 | 24 | 1431 | 29 (27 to 31) | 96 (95 to 97) | 95 | 1.88 | Moderate |
| Poor rapport between women and providers | |||||||||
| Supportive care: Woman had a companion present during labour and childbirth (N=1518) | 107 | 70 | 444 | 897 | 19 (17 to 21) | 93 (91 to 94) | 66 | 0.32 | High |
| Autonomy | |||||||||
| Woman did not have easy access to water or oral fluids during labour§ (N=1312) | 150 | 92 | 371 | 686 | 29 (24 to 34) | 88 (85 to 91) | 64 | 0.46 | High |
| Woman not told she could and did not mobilise during labour (N=1522) | 840 | 165 | 158 | 359 | 84 (82 to 86) | 69 (66 to 71) | 78 | 1.01 | Low |
*Risk of bias: IF as low (0.75<IF<1.5), moderate (0.50<IF<0.75 or 1.5<IF<2.0) or high (IF≤0.50 or IF≥2.0).
†Threats of medical procedure, physical violence, poor baby outcome, withholding care.
‡Negative comments regarding the woman’s or baby’s appearance, or mother’s sexual activity.
§Among women with vaginal births only.