Table 4.
Birth characteristics associated with upsetting experiences of disrespect and abuse among multiparous women (n = 4,904)
| Any category of disrespect and abuse | Emotional pressure | Unfriendly behaviour/ verbal abuse | Use of force/ physical violence | Communication issues | Lack of support | Lack of consent | Discrimination | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | AOR (95% CI) | OR (95% CI) | AOR (95% CI) | OR (95% CI) | AOR (95% CI) | OR (95% CI) | AOR (95% CI) | OR (95% CI) | AOR (95% CI) | OR (95% CI) | AOR (95% CI) | OR (95% CI) | AOR (95% CI) | OR (95% CI) | ||
| Onset of labour | Spontaneous | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| Induction | 2.27 (1.97 – 2.62) | 1.09 (0.90 – 1.32) | 1.39 (0.89 – 2.16) | 0.88 (0.51 – 1.52) | 2.06 (1.59 – 2.68) | 0.97 (0.70 – 1.35) | 1.87 (1.51 – 2.30) | 0.94 (0.71 – 1.22) | 2.06 (1.72 – 2.46) | 1.01 (0.80 – 1.28) | 2.19 (1.81 – 2.64) | 1.13 (0.88 – 1.44) | 2.19 (1.85 – 2.59) | 1.15 (0.92 – 1.44) | 1.88 (0.73 – 4.85) | |
| C-section | 1.68 (1.33 – 2.11) | 0.91 (0.34 – 2.45) | 0.71 (0.29 – 1.78) | - | 1.63 (1.07 – 2.50) | 0.39 (0.10 – 1.46) | 1.03 (0.70 – 1.53) | - | 2.03 (1.54 – 2.67) | 1.45 (0.40 – 5.32) | 2.06 (1.55 – 2.76) | 0.85 (0.27 – 2.72) | 0.65 (0.45 – 0.94) | 0.55 (0.15 – 2.05) | 4.08 (1.41 – 11.80) | |
| Healthcare provider throughout birth | Midwife-led care | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| Transfer of carea | 3.90 (3.21 – 4.74) | 1.94 (1.45 – 2.60) | 5.20 (2.95 – 9.14) | 1.34 (0.50 – 3.56) | 5.44 (3.66 – 8.07) | 2.26 (1.17 – 4.35) | 5.84 (4.31 – 7.92) | 2.57 (1.58 – 4.16) | 4.80 (3.72 – 6.19) | 1.74 (1.16 – 2.62) | 3.67 (2.81 – 4.86) | 1.93 (1.26 – 2.94) | 4.24 (3.36 – 5.36) | 2.04 (1.42 – 2.93) | 2.764 (0.59 – 11.81) | |
| Obstetrician-led care | 3.97 (3.42 – 4.61) | 1.67 (1.22 – 2.28) | 2.69 (1.60 – 4.53) | 0.65 (0.24 – 1.77) | 5.21 (3.72 – 7.30) | 1.73 (0.88 – 3.42) | 4.47 (3.44 – 5.81) | 1.80 (1.08 – 3.00) | 4.44 (3.60 – 5.47) | 1.34 (0.87 – 2.05) | 4.22 (3.40 – 5.23) | 1.83 (1.18 – 2.86) | 3.34 (2.76 – 4.04) | 1.45 (0.99 – 2.13) | 4.98 (1.66 – 14.91) | |
| Pain relief during labour | None | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| Epidural | 2.89 (2.34 – 3.56) | 1.12 (0.88 – 1.44) | 1.75 (0.94 – 3.28) | 0.72 (0.35 – 1.48) | 3.16 (2.24 – 4.45) | 1.24 (0.83 – 1.85) | 2.53 (1.89 – 3.38) | 1.05 (0.75 – 1.47) | 2.58 (2.01 – 3.32) | 0.94 (0.70 – 1.27) | 2.67 (2.06 – 3.47) | 1.25 (0.92 – 1.71) | 2.45 (1.93 – 3.11) | 0.97 (0.73 – 1.28) | 2.45 (0.68 – 8.82) | |
| Remifentanil | 2.29 (1.83 – 2.86) | 0.97 (0.75 – 1.25) | 2.10 (1.14 – 3.86) | 0.86 (0.44 – 1.69) | 2.86 (1.98 – 4.13) | 1.14 (0.75 – 1.73) | 2.94 (2.20 – 3.93) | 1.25 (0.90 – 1.74) | 2.57 (1.98 – 3.34) | 1.05 (0.78 – 1.42) | 2.58 (1.96 – 3.40) | 1.37 (1.00 – 1.87) | 2.13 (1.65 – 2.75) | 0.93 (0.69 – 1.24) | 2.70 (0.75 – 9.71) | |
| Otherb | 3.74 (2.35 – 5.96) | 2.30 (1.37 – 3.85) | 3.36 (1.19 – 9.48) | 1.62 (0.48 – 5.62) | 5.13 (2.75 – 9.55) | 2.86 (1.40 – 5.80) | 3.06 (1.68 – 5.55) | 1.41 (0.70 – 2.83) | 2.95 (1.73 – 5.03) | 1.54 (0.84 – 2.83) | 2.99 (1.72 – 5.21) | 1.75 (0.94 – 3.25) | 3.90 (2.40 – 6.33) | 2.27 (1.31 – 3.94) | 4.60 (0.59 – 36.06) | |
| Place of birth | Home | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| Midwife-led institutionalc | 1.56 (1.25 – 1.96) | 1.37 (1.08 – 1.75) | 0.94 (0.37 – 2.39) | 0.82 (0.27 – 2.48) | 1.78 (0.99 – 3.18) | 1.29 (0.67 – 2.49) | 1.22 (0.79 – 1.89) | 1.01 (0.64 – 1.61) | 1.38 (0.98 – 1.94) | 1.25 (0.87 – 1.81) | 1.99 (1.41 – 2.80) | 1.73 (1.19 – 2.52) | 1.48 (1.10 – 1.99) | 1.29 (0.93 – 1.77) | 1.61 (0.23 – 11.45) | |
| Obstetrician-led hospitald | 4.78 (4.02 – 5.68) | 2.55 (1.83 – 3.55) | 4.16 (2.26 – 7.67) | 7.87 (2.57 – 24.06) | 7.31 (4.70 – 11.38) | 3.80 (1.79 – 8.06) | 5.24 (3.86 – 7.11) | 2.66 (1.55 – 4.57) | 5.46 (4.25 – 7.02) | 3.37 (2.13 – 5.34) | 5.20 (3.97 – 6.81) | 2.38 (1.47 – 3.88) | 4.23 (3.38 – 5.29) | 2.69 (1.79 – 4.04) | 6.05 (1.41 – 26.03) | |
| Mode of birth | Spontaneous | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| Planned C-section | 1.42 (1.12 – 1.80) | 0.96 (0.48 – 2.00) | 0.47 (0.15 – 1.51) | 0.37 (0.05 – 2.84) | 1.40 (0.89 – 2.21) | 0.56 (0.19 – 1.66) | 0.98 (0.65 – 1.49) | 2.34 (0.62 – 8.81) | 1.74 (1.29 – 2.33) | 1.12 (0.51 – 2.46) | 1.77 (1.31 – 2.39) | 1.03 (0.44 – 2.41) | 0.58 (0.40 – 0.86) | 1.12 (0.42 – 3.01) | 3.41 (1.11 – 10.51) | |
| Spontaneous with episiotomy | 1.61 (1.286– 2.07) | 1.09 (0.83 – 1.4) | 1.09 (0.47 – 2.52) | 0.63 (0.24 – 1.60) | 1.29 (0.79 – 2.13) | 0.82 (0.48 – 1.40) | 1.32 (0.89 – 1.96) | 0.81 (0.53 – 1.25) | 1.52 (1.10 – 2.10) | 1.05 (0.74 – 1.48) | 1.37 (0.97 – 1.93) | 0.92 (0.64 – 1.34) | 1.59 (1.19 – 2.14) | 1.15 (0.84 – 1.58) | - | |
| Assisted vaginal birth | 5.25 (3.49 – 7.89) | 2.55 (1.63 – 3.99) | 2.88 (1.14 – 7.29) | 1.18 (0.41 – 3.45) | 4.88 (2.90 – 8.21) | 2.26 (1.27 – 4.01) | 5.48 (3.53 – 8.51) | 2.42 (1.49 – 3.95) | 4.80 (3.16 – 7.29) | 2.25 (1.42 – 3.57) | 2.65 (1.65 – 4.28) | 1.29 (0.76 – 2.19) | 4.83 (3.22 – 7.25) | 2.72 (1.74 – 4.24) | 2.98 (0.39 – 22.96) | |
| Unplanned C-section | 4.62 (3.57– 5.98) | 2.23 (1.62 – 3.08) | 2.92 (1.59 – 5.35) | 1.77 (0.85 – 3.67) | 4.31 (3.01 – 6.16) | 1.66 (1.04 – 2.64) | 4.23 (3.12 – 5.74) | 2.43 (1.68 – 3.52) | 5.75 (4.40 – 7.52) | 2.91 (2.08 – 4.07) | 3.81 (2.86 – 5.07) | 1.73 (1.20 – 2.49) | 3.59 (2.74 – 4.71) | 2.21 (1.58 – 3.08) | 5.86 (2.07 – 16.55) | |
For some of the comparisons, groups were too small to calculate AORs
OR Odds ratio, AOR Adjusted odds ratio, CI Confidence interval, C-section Caesarean section
aTransfer from midwife-led care to obstetrician-led care
bSterile water injection, Entonox or pethidine
cBirth centre or hospital with community midwife
dHospital with hospital-based care provider (medical indication)