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This paper provides a synthesis of current knowledge about post-traumatic stress symptoms following childbirth. In particular it presents a two dimensional conceptual framework for understanding the development of symptoms based upon predisposing (pre-pregnancy/pregnancy), precipitating (perinatal) and maintaining (postnatal) factors, which relate to internal (within individual), external (environmental) and interactional factors. In addition key methodological issues and areas for further research are identified. [ABSTRACT FROM AUTHOR]

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Respectful maternity care is a fundamental human right, and an important component of quality maternity care. The aim of this study was to quantify the frequency and categories of D&A and identify factors associated with reporting D&A among women in north Showa zone of Ethiopia. A cross-sectional study was conducted with 435 randomly selected women who had given birth at public health facility within the previous 12 months in North Showa zone of Ethiopia. A digital (tablet-based) structured and researcher administered tool was used for data collection. Frequencies of D&A items organised around the Bowser and Hill categories of D&A and presented in the White Ribbon Alliance's Universal Rights of Childbearing Women Framework were calculated. Multivariable logistic regression was used to identify the association between experience of disrespect and abuse and interpersonal and structural factors at p-value <0.05 and odds ratio values with 95% confidence interval. All participants reported at least one form of disrespect and abuse during childbirth. Types of disrespect and abuse experienced by participants were physical abuse 435 (100%), non-consented care 423 (97.2%), non-confidential care 288 (66.2%), abandonment/neglect (34.7%), non-dignified care 126 (29%), discriminatory care 99 (22.8%) and detention 24 (5.5%). Hospital birth [AOR: 3.04, 95% CI: 1.75, 5.27], rural residence [AOR: 1.44, 95% CI: 0.76, 2.71], monthly household income less than 1,644 Birr (USD 57) [AOR: 2.26, 95% CI: 1.20, 4.26], being attended by female providers [AOR: 1.74, 95% CI: 1.06, 2.86] and midwifery nurses [AOR: 2.23, 95% CI: 1.13, 4.39] showed positive association with experience of disrespect and abuse. Hospital birth showed consistent association with all forms of disrespect and abuse. Expanding the size and skill mix of professionals in the hospitals, sensitizing providers consequences of disrespect and abuse could promote dignified and respectful care. [ABSTRACT FROM AUTHOR]

Social researchers of childbirth have argued that techno-medical routines of managing childbirth risk are underpinned by worst case scenarios involving disastrous deliveries, with catastrophic consequences for maternal and neonatal health and life. This article looks into childbirth stories that ended safely amidst serious ruptures in techno-medical surveillance. We draw on the childbirth stories of women who gave birth during the 11 March 2011 disasters recorded by the first author in February 2016 and on an array of childbirth stories published in a journalistic book in 2012. The stories reveal the navigations of women and care providers between two different types of risks: risks associated with birth in the techno-medicalised model of care and risks associated with earthquakes. Underlying the safety management imperatives of each are divergent space and time lines. Significantly, the techno-medical surveillance of risk associated with childbirth proved to be secondary to the earthquake risk. Rather than high technologies, it was low-tech necessities and human care that proved crucial for the management of safe births. Though women interpreted the safe conclusion of their birth as miracle, their stories suggest that childbirth, especially when attended by skilled birth attendants, can take place relatively safely, even in the direst of conditions. Accounts of childbirth in the midst of disasters offer evidence and important insights in developing a critique of technological birth in the social scientific and midwifery literature. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on the topics including impact of technology on pregnancy and childbirth; creating and managing obstetrical risk in different cultural and socio-economic contexts; and analyze the processes of technomedicalisation.

Objective: The current study aimed to evaluate the profile of women who are most likely to undergo caesarean delivery on maternal request (CDMR) and clarify their reasons for this decision. Methods: For this multicentre case–control study, data were collected from 429 women who underwent CDMR and 429 matched controls who delivered vaginally from June, 2008 through February, 2009. Participants were interviewed by telephone regarding sociodemographic variables, health and lifestyle. Results: CDMR predictors were as follows: increasing age (OR = 1.09/year; 95%CI: 1.05–1.14), family status (unmarried without a steady partner versus married – OR = 3.60; 95%CI: 1.08–11.97), decreasing level of religiosity (secular versus ultra-orthodox – OR = 11.82; 95%CI: 3.75–37.21), and never having engaged, or ceasing sports activity during pregnancy (OR = 1.79; 95%CI: 1.09–2.91 and 2.38; 95%CI: 1.28–4.43, respectively). Above average income reduced the probability of CDMR (OR = 0.56; 95%CI: 0.33–0.94). The most frequent reasons for choosing CDMR were concern for pain (21.9%), concern for their own or baby's health (20.4% and 16.5%, respectively) and emotional aspects (10.0%). Conclusions: Older, unmarried and/or secular women had increased probability of CDMR. Addressing specific concerns regarding vaginal delivery may provide the basis for a patient-oriented intervention for preventing unnecessary surgery. [ABSTRACT FROM PUBLISHER]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Persistently high maternal mortality levels are a concern in developing countries. In India, monetary incentive schemes have increased institutional delivery rates appreciably, but have not been equally successful in reducing maternal mortality. Maternal outcomes are affected by quality of obstetric care and socio-cultural norms. In this light there is need to examine the quality of care provided to women delivering in institutions. Objective: This study aimed to examine pregnant women's expectations of high-quality care in public health facilities in Uttar Pradesh, India, and to contrast this with provider's perceptions of the same, as well as the barriers that limit their ability to provide high-quality care. Methods: A qualitative descriptive analysis was conducted on data from two studies - focus group discussions with rural women in their last trimester of pregnancy (conducted in 2014) to understand women's experience and satisfaction with maternal care services, and in-depth interviews with care providers (conducted in 2016-17) to understand provision of person-centred care. Provider perspectives were matched with themes of women's perspectives on quality of childbirth care in facilities. Results: Major themes of care prioritised by women included availability of doctors at the facility; availability of medicines; food; ambulance services; maintenance of cleanliness and hygiene; privacy; good and safe delivery with no complications; client-provider interaction; financial cost of care. Many women also voiced no expectation of care, indicating disillusionment from the existing system. Providers concurred with women on all themes of care except availability of doctors, as they felt that trained nurses were proficient in conducting deliveries. Conclusions: This study shows that women have clear expectations of quality care from facilities where they go to deliver. Understanding their expectations and matching them with providers' perspectives of care is critical for efforts to improve the quality of care and thereby impact maternal outcomes. [ABSTRACT FROM AUTHOR]

Access to facility delivery in India has significantly increased with the Janani Suraksha Yojana (JSY) cash transfer programme to promote facility births. However, a decline in maternal mortality has only followed secular trends as seen from the beginning of the decade well before the programme began. We, therefore, examined the quality of intrapartum care provided in facilities under the JSY programme to study whether it ensures skilled attendance at birth. 1) Non-participant observations (n=18) of intrapartum care during vaginal deliveries at a representative sample of 11 facilities in Madhya Pradesh to document what happens during intrapartum care. 2) Interviews (n=10) with providers to explore reasons for this care. Thematic framework analysis was used. Three themes emerged from the data: 1) delivery environment is chaotic: delivery rooms were not conducive to safe, women-friendly care provision, and coordination between providers was poor. 2) Staff do not provide skilled care routinely: this emerged from observations that monitoring was limited to assessment of cervical dilatation, lack of readiness to provide key elements of care, and the execution of harmful/unnecessary practices coupled with poor techniques. 3) Dominant staff, passive recipients: staff sometimes threatened, abused, or ignored women during delivery; women were passive and accepted dominance and disrespect. Attendants served as 'go-betweens' patients and providers. The interviews with providers revealed their awareness of the compromised quality of care, but they were constrained by structural problems. Positive practices were also observed, including companionship during childbirth and women mobilising in the early stages of labour. Our observational study did not suggest an adequate level of skilled birth attendance (SBA). The findings reveal insufficiencies in the health system and organisational structures to provide an 'enabling environment' for SBA. We highlight the need to ensure quality obstetric care prior to increasing coverage of facility births if cash transfer programmes like the JSY are to improve health outcomes. [ABSTRACT FROM AUTHOR]