Table 1.
Attributes | Attribute levels |
Failure to meet standards of care | Lack of informed consent and confidentiality: birth attendant may not ask for your permission before performing any medical examination or procedure and may discuss your personal information openly with others. |
Physical examinations and procedures: birth attendant may not give you pain relief as necessary (eg, during examination) or for the stitching of episiotomy. | |
Neglect and abandonment: birth attendant may leave you unattended, you may deliver without assistance. | |
Meet professional standards of care: Birth attendant will take care of you throughout labour and delivery, will ask for your consent, provide pain relief when needed. | |
Poor rapport with providers | Poor communication: birth attendant may not explain what will happen to you or your baby and may not encourage you to ask questions or answer your questions. |
Lack of supportive care: birth attendant will not empathise or show genuine interest in your well-being. | |
Loss of autonomy: birth attendant will not allow a companion to stay with you and will not allow you to eat, drink, move about or choose your preferred birth position. | |
Good rapport with providers: Birth attendant will receive you with open arms, comfort and encourage you, respond to you in friendly way, allow you to have a companion and to choose your preferred birth position. | |
Health system constraints | Staffing constraints: qualified birth attendant not available to assist with your delivery. |
Drugs and supply constraints: drugs and supplies needed for delivery not available. | |
Poor facility culture: birth environment unclean, smelly, with mosquitoes, with no privacy, user fee not clear. | |
Good health system conditions: qualified birth attendant present to assist you and drugs and supplies needed for delivery available, clean and conducive birth environment. | |
Physical and verbal abuse | Physical and verbal abuse: birth attendant may hit, slap or put restraints on you, shout or insult you. |
No physical and verbal abuse: birth attendant will not hit, slap or put restraints on you and will not shout or insult you. | |
Sexual abuse | Sexual abuse: birth attendant may touch your body parts or private parts inappropriately. |
No sexual abuse: birth attendant will not touch your body parts or private inappropriately. | |
Stigma and discrimination | Discrimination: birth attendant may discriminate against you because you are poor, from a village, not educated or because of your religion, tribe or disease condition. |
No discrimination: birth attendant will not discriminate against you because you are poor, from a village, not educated or because of your religion, tribe or disease condition. |
Attributes and attribute levels derived from literature review,3 and revised based on qualitative findings.