A qualitative exploration of the mistreatment of women during childbirth in a rural Guatemalan hospital.

backgroundIn Guatemala, many women still give birth together with traditional birth attendants at home particularly in rural settings even though births attended by skilled birth attendants in healthcare facilities have been recommended. Mistreatment of women during childbirth is recognized as one of the obstacles to childbirth in healthcare facilities. However, little research has been conducted on childbirth care and the mistreatment of women during facility-based childbirth in Guatemala. Thus, this study aimed to explore women’s experiences of care during childbirth in a rural Guatemalan hospital. The women narrated their experiences from which themes were derived (whether mistreatment or not, and if mistreatment prevailed, the type).

methodsThis qualitative study involved interviews with 20 women of reproductive age who had given birth in a hospital in Quiché Department, Guatemala, within the past six months. Data were collected by semistructured interviews between December 2022 and February 2023. The contents of the semistructured interviews were past birth experiences, a recent birth experience in a hospital, and care received from healthcare providers. Thematic analysis was performed with deductive and inductive approaches using Bohren et al.’s typology of the mistreatment of women during childbirth. The study was approved by St. Luke’s International University Research Ethics Committee and the study hospital.

resultsWomen reported experiencing various forms of mistreatment during childbirth in the rural Guatemalan hospital. These included six of the seven categories from Bohren et al.’s typology including physical abuse, verbal abuse, stigma and discrimination, failure to meet professional standards of care, poor rapport between women and providers, and health system conditions and constraints. Specifically, the participants reported experiences of reprimands and neglect by healthcare providers, as well as discrimination of those who do not speak Spanish. It became evident that mistreatment of women by healthcare providers had become normalized, and that culturally appropriate care was not adequately provided.

conclusionsEliminating or reducing mistreatment requires a multilevel approach. Healthcare providers must acquire up-to-date knowledge and skills and develop appropriate professional attitudes. Both healthcare providers and women should have increased awareness of women’s rights and mistreatment.