Observations and reports of incidents of how birthing persons are treated during childbirth in two public facilities in Argentina

Objective: This study sought to estimate the frequency and types of mistreatment during childbirth and explore health professionals' opinions on barriers/facilitators to providing respectful childbirth care.

Methods: This prospective mixed-methods investigation consisted of direct observations of childbirth (n = 250), at-home surveys with birthing individuals (n = 45), and qualitative in-depth health staff interviews (n = 6), conducted between January and July 2019, in two public facilities in Argentina. Frequencies of clinical practices and mistreatment and 5% confidence intervals were calculated. A logistic regression analysis was also conducted to examine associations between mistreatment and covariates of interest, with P < 0.05 considered statistically significant.

Results: Overall, 61/250 (24.4%, confidence interval 19.6%-30.6%) observations recorded instances of mistreatment; 20/45 surveyed participants (44.4%) reported at least one episode of mistreatment. The most frequent perpetrators were physicians (35.6%), birth companions (24.4%), midwives (22.2%), and nurses (13.3%). Participants with lower educational attainment and those racialized as non-white had higher odds of being mistreated. Health providers reported that respectful childbirth is currently widely implemented due to authorities' and communities' awareness on respectful birth´s rights.

Conclusion: Almost a quarter of birthing people were observed to suffer mistreatment - primarily verbal abuse - and 44.4% of surveyed individuals reported mistreatment. Future research is needed to determine how to ensure the provision of respectful childbirth care for all. A quarter of participants experienced mistreatment; mostly those with lower educational attainment and/or racialized as non-white. Further research on implementation of respectful childbirth is warranted.