Abstract:
Objectives: An increasing body of evidence has revealed
disrespectful and abusive care in facility-based childbirth as
a barrier to maternal and child health. Providers have noted
subpar work environments, inadequate staffing, and negative attitudes toward marginalized groups as barriers to
respectful care. What has not been studied is the impact of
disaster and violence on the delivery of respectful maternity
care. The purpose of this study was to evaluate the state of
obstetrical care in a maternity hospital in Odessa, Ukraine
during a time of military invasion.
Methods: We surveyed 202 maternity care providers who
have worked at Odessa City Maternity Hospital № 5 for at
least one year. Measurements and topics covered in the
questionnaires included respectful care practices performed; types of disrespectful behaviors witnessed; the
impact of war on the provision of respectful maternity care;
post-traumatic stress; and attitudes about consent in
obstetric care.
Results: Fifty percent of respondents believed disrespect
was an issue in the field of obstetrics. A slight majority
(55.0 %) reported that the frequency of disrespect and abuse
remained the same before and after the invasion, while
32.2 % reported a lower frequency and 9.4 % reported a
higher frequency of disrespect. There was little change in
reported performance of respectful maternity care before
and after the full-scale invasion.
Conclusions: Reported effects of war on respectful maternity care were minimal. However, the relatively low
knowledge of disrespect and the large spread of frequency of
reported respectful behavior indicate an opportunity for
training.
