Table 3.

Disrespectful postnatal care

Disrespectful maternity care
Themes	Sub themes	Content quotes
Stigma and discrimination based on specific attributes	Birth-place related stigma [40, 43, 45, 47]	“They tell us to come back when we can explain ourselves to see if they are satisfied with the explanation [for having delivered at home].” – [45] “If a woman gives birth at home, the HEWs [health extensions workers] won’t hear about it. Nobody tells them that she has given birth” – [40]
	Stigma related to HIV status [39, 46, 50]	“When you get there, they are shouting at you as if you are a small child, that why I think people stop going to clinics.” – [39]
	Age related discrimination [36, 40, 49]	“They were just talking, saying I am so uncooperative and yet I am so young and why am I doing all these things if I am not going to be able to face up to it” – [49]
	Discrimination due to socio-economic status [36, 50]	"At [public hospital], they [nursing staff] were shouting. They say you foreigner, come to make a baby here." – [50] “…one would never go wrong with the midwives if they came for their check-ups well groomed” – [36]
Non-dignified and disrespectful care	Negative attitude of health care providers [36, 42, 43, 49]	"When we go late to the clinic for postnatal care, the healthcare providers complain that they are getting a meagre salary and yet we keep bothering them" – [42] “Attitude, the way sometimes patients get treated, it’s not OK for me…sometimes you find that people are afraid to ask certain things because you find that health workers can’t be approached …it’s not OK the way that they deal with patients. I am not happy.”—[39]
	Power imbalance [36–38, 45]	“Some of the midwives are not approachable. If you try to exercise your rights it appears as if you are going too forward ahead of the midwives” – [36]
	Hostile environment [[36, 38]]	“Many pregnant mothers are waiting. When you leave, another woman gets the bed. Our wards are few and we are many. Like if you were to continue staying you would bring trouble for others… and the nurses tell us, ‘Now the time has come. You should go so that others can come.’” – [38]
Abuse	Physical abuse [39, 43, 45–47]	“No we did not go to the hospital [for postnatal care] because if they notice that you delivered from the village … her [the nurse] can easily beat you. So it is better I go to the old lady in the village because I know she will treat me well.” – [45]
Denial of care	Denial of postnatal care after delivering [38, 40, 42, 45, 47]	“Stay longer … if you have delivered safely you can’t stay. The only time they say you stay for 24 h is if you have problems. We know the rules.” –[38]
	Denial of care as a punitive measure [40, 45, 47]	“Me, after delivering I spent 1 week when I had no problem; even the baby was suckling and sleeping well. After 3 days she got fever and she was really badly off. I said let me take her to the facility, maybe I would be helped. They told me the medicine is not there for me [because I had delivered at home].” – [45] “If you go to the clinic after giving birth at home, nurses make you pay before they examine your baby” – [47] “I didn’t go [for postnatal care] because I didn’t have ZMW51 to pay for the card.”- [45]
	Lack of informed care [36, 38, 39, 42, 43, 45, 49]	“I do not have much understanding of the programme [maternal health services]. I am a first-time mother, so I don't know about many things. Neither do the midwives see the needs to tell me anything.” – [36] “No. They’re [new mothers] not supposed to go to the clinic if the baby is OK and they are OK. I don’t see the point of me always being at the clinic. What will I be doing there? Because the baby is healthy and I am healthy.” – [39]