Poster Session 4
Volodymyr V. Artyomenko, Professor, DSc(Med), MD, PhD (he/him/his)
Professor of Obstetrics and Gynecology
Odesa National Medical University
Odesa, Odes'ka Oblast', Ukraine
Annekathryn Goodman, MD, MPH, MS
Obstetrician-Gynecologist
Massachusetts General Hospital
Boston, Massachusetts, United States
Igor Shpak, MD, PhD
Director
Maternity Hospital No 5
Odesa, Odes'ka Oblast', Ukraine
Mary Greenwald
Program Coordinator
Strength and Serenity Initiative Against Gender-Based Violence, Massachusetts General Hospital
Boston, Massachusetts, United States
Marcella Regina Cardoso, MSc, PhD
Postdoctoral Research Fellow
Strength and Serenity Initiative Against Gender-Based Violence, Massachusetts General Hospital
Boston, Massachusetts, United States
Katherine D. Fachon, MPH (she/her/hers)
Research Coordinator
Strength and Serenity Initiative Against Gender-Based Violence, Massachusetts General Hospital
Boston, MA, United States
Christina M. Duzyj, MD, MPH (she/her/hers)
Director, Maternal Fetal Medicine Fellowship Program
Massachusetts General Hospital
Boston, MA, United States
Respectful maternity care (RMC) is a fundamental right of birthing people. Our objectives were: to measure the proportion of obstetric providers at an Odesa Maternity Hospital reporting disrespect and abuse (D&A) during childbirth; to identify challenges to RMC; and to assess perceptions of the impact of war on RMC.
Study Design:
This is a cross-sectional study consisting of a quantitative survey distributed to physicians, nurses, midwives, and other personnel at Odesa City Maternity Hospital № 5. The survey included 90 questions assessing prevalence and types of disrespect. Topics covered included: RMC practices performed; disrespectful behaviors witnessed; the impact of war on the provision of RMC; Perceived Stress Scale and Post-Traumatic Stress Scale; perspectives on patient autonomy and decision-making. Results were compared with a survey administered in a Boston maternity unit.
Results:
202 Providers responded: 89 nurses and junior nurses, 28 midwives, 84 physicians, and 1 unknown provider. 49.5% were familiar with the term “disrespect and abuse,” compared with 82.6% in Boston; and 50.0% believed D&A exists in the obstetrics field, compared with 84.8% in Boston. The most reported types of disrespect were scolding or blaming (58.4% compared with 63% in Boston), asking private questions in the presence of others (42.1% vs 58.7%) and uncomfortable vaginal examinations (39.6% vs. 65.2%). The most common types of discriminatory care witnessed were discrimination based on social status (38.6% vs. 28.3%) and ability to pay “pocket money” (37.1%).
Conclusion:
This study provides insights into the provision of maternity care under conditions of duress, and highlights challenges faced under the strains of conflict. These efforts aim to identify gaps in education and training around RMC in order to enhance maternal healthcare delivery in conflict-affected regions, fostering a more supportive and respectful environment for providers and patients.
