Mistreatment of women during childbirth and postpartum depression: secondary analysis of WHO community survey across four countries.

Journal: BMJ global health

Volume: 8

Issue: 8

Year of Publication: 2023

Affiliated Institutions:  Department of Biostatistics, School of Public Health, University of Ghana, Legon, Ghana. Department of Health Information Management, College of Health and Well-Being, Kintampo, Ghana. Department of Obstetrics Gynaecology, University of Ghana Medical School, University of Ghana, Accra, Ghana. Department of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneve, Switzerland. Reproductive and Maternal Health, and Healthy Ageing Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Democratic Republic of Congo. Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, University of Medical Sciences, Akure, Ondo State, Nigeria. Cellulle de Recherche en Sante de la Reproduction en Guinee (CERREGUI), Conakry, Guinea. Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria. Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar. Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Legon-Accra, Ghana emaya@ug.edu.gh.

Abstract summary 

Postpartum depression (PPD) is a leading cause of disability globally with estimated prevalence of approximately 20% in low-income and middle-income countries. This study aims to determine the prevalence and factors associated with PPD following mistreatment during facility-based childbirth.This secondary analysis used data from the community survey of postpartum women in Ghana, Guinea, Myanmar and Nigeria for the WHO study, 'How women are treated during facility-based childbirth'. PPD was defined using the Patient Health Questionnaire (PHQ-9) tool. Inferential analyses were done using the generalised ordered partial proportional odds model.Of the 2672 women, 39.0% (n=1041) developed PPD. 42.2% and 5.2% of mistreated women developed minimal/mild PPD and moderate/severe PPD, respectively. 43.0% and 50.6% of women who experienced verbal abuse and stigma/discrimination, respectively developed minimal/mild PPD. 46.3% of women who experienced physical abuse developed minimal/mild PPD while 7.6% of women who experienced stigma/discrimination developed moderate/severe PPD. In the adjusted model, women who were physically abused, verbally abused and stigma/discrimination compared with those who were not were more likely to experience any form of PPD ((OR: 1.57 (95% CI 1.19 to 2.06)), (OR: 1.42 (95% CI 1.18 to 1.69)) and (OR: 1.69 (95% CI 1.03 to 2.78))), respectively. Being single and having higher education were associated with reduced odds of experiencing PPD.PPD was significantly prevalent among women who experienced mistreatment during childbirth. Women who were single, and had higher education had lower odds of PPD. Countries should implement women-centred policies and programmes to reduce mistreatment of women and improve women's postnatal experiences.

Authors & Co-authors:  Guure Chris C Aviisah Philomina Akandity PA Adu-Bonsaffoh Kwame K Mehrtash Hedieh H Aderoba Adeniyi Kolade AK Irinyenikan Theresa Azonima TA Balde Mamadou Dioulde MD Adeyanju Olusoji O Maung Thae Maung TM Tunçalp Özge Ö Maya Ernest E

Study Outcome 

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Statistics
Citations :  Zampas C, Amin A, O’Hanlon L, et al. . Operationalizing a human rights-based approach to address mistreatment against women during childbirth. Health Hum Rights 2020;22:251–64. Available: https://pubmed.ncbi.nlm.nih.gov/32669805/
Authors :  11
Identifiers
Doi : e011705
SSN : 2059-7908
Study Population
Women,Female
Mesh Terms
Female
Other Terms
Community-based survey;Maternal health;Mental Health & Psychiatry
Study Design
Study Approach
Country of Study
Niger
Publication Country
England