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2017 ; 14
(1
): 66
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Defining disrespect and abuse of newborns: a review of the evidence and an
expanded typology of respectful maternity care
#MMPMID28545473
Sacks E
Reprod Health
2017[May]; 14
(1
): 66
PMID28545473
show ga
Amid increased attention to quality of obstetric care and respectful maternity
care globally, insufficient focus has been given to quality of care and
respectful care for newborns in the postnatal period. Especially in low and
middle income countries, where low utilisation of obstetric and neonatal services
is of concern, it is plausible that poor quality of care or mistreatment of
newborns or stillborn infants will influence future care seeking, both for the
health care needs of the growing infant and for subsequent pregnancies.
Preliminary evidence indicates that mistreatment of newborns exists, both in the
immediate and later postnatal periods. Definitions have been developed for
instances of mistreatment of women during labour and delivery, but how newborns
fit into the categorisations and critical questions around how to conceptualise
dignified care for newborns have not been well addressed.The WHO recently
published "Standards for improving quality of maternal and newborn care in health
facilities", which provides a series of clinical and experiential standards that
health facilities should strive to provide for all patients. Presented here are a
number of the experiential measures, as well as health system requirements, which
could be further developed to encompass the explicit needs of newborns and
stillborn infants, and their families. Specific WHO Standards that require more
attention for newborns are those related to effective communication, informed
consent and emotional support (including for bereaved families).Using seven
categories previously developed for respectful maternity care generally, a
literature review was conducted on mistreatment of newborns. The review revealed
examples of mistreatment of newborns in six of the seven categories. Common
occurrences were failure to meet a professional standard of care, stigma and
discrimination, and health system constraints. Many instances of mistreatment of
newborns related to neglect and non-consented care rather than outright physical
or verbal abuse. Two additional categories were also identified for newborns
related to legal accountability and bereavement care.More research is needed into
the prevalence of disrespect, abuse, and stigmatisation of newborns and further
discussions are needed about how to provide quality care for all patients,
including the smallest and most vulnerable.