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      Left powerless: A qualitative social media content analysis of the Dutch #breakthesilence campaign on negative and traumatic experiences of labour and birth

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          Abstract

          Introduction

          Disrespect and abuse during labour and birth are increasingly reported all over the world. In 2016, a Dutch client organization initiated an online campaign, #genoeggezwegen (#breakthesilence) which encouraged women to share negative and traumatic maternity care experiences. This study aimed (1) to determine what types of disrespect and abuse were described in #genoeggezwegen and (2) to gain a more detailed understanding of these experiences.

          Methods

          A qualitative social media content analysis was carried out in two phases. (1) A deductive coding procedure was carried out to identify types of disrespect and abuse, using Bohren et al.’s existing typology of mistreatment during childbirth. (2) A separate, inductive coding procedure was performed to gain further understanding of the data.

          Results

          438 #genoeggezwegen stories were included. Based on the typology of mistreatment during childbirth, it was found that situations of ineffective communication, loss of autonomy and lack of informed consent and confidentiality were most often described. The inductive analysis revealed five major themes: ‘‘lack of informed consent”; ‘‘not being taken seriously and not being listened to”; ‘‘lack of compassion”; ‘‘use of force”; and ‘‘short and long term consequences”. “Left powerless” was identified as an overarching theme that occurred throughout all five main themes.

          Conclusion

          This study gives insight into the negative and traumatic maternity care experiences of Dutch women participating in the #genoeggezwegen campaign. This may indicate that disrespect and abuse during labour and birth do happen in the Netherlands, although the current study gives no insight into prevalence. The findings of this study may increase awareness amongst maternity care providers and the community of the existence of disrespect and abuse in Dutch maternity care, and encourage joint effort on improving care both individually and systemically/institutionally.

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          Most cited references35

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          Shared decision making: really putting patients at the centre of healthcare

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            Pain and women's satisfaction with the experience of childbirth: a systematic review.

            To summarize what is known about satisfaction with childbirth, with particular attention to the roles of pain and pain relief. A systematic review of 137 reports of factors influencing women's evaluations of their childbirth experiences. The reports included descriptive studies, randomized controlled trials, and systematic reviews of intrapartum interventions. Results were summarized qualitatively. Four factors-personal expectations, the amount of support from caregivers, the quality of the caregiver-patient relationship, and involvement in decision making-appear to be so important that they override the influences of age, socioeconomic status, ethnicity, childbirth preparation, the physical birth environment, pain, immobility, medical interventions, and continuity of care, when women evaluate their childbirth experiences. The influences of pain, pain relief, and intrapartum medical interventions on subsequent satisfaction are neither as obvious, as direct, nor as powerful as the influences of the attitudes and behaviors of the caregivers.
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              Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis

              Background What constitutes respectful maternity care (RMC) operationally in research and programme implementation is often variable. Objectives To develop a conceptualisation of RMC. Search strategy Key databases, including PubMed, CINAHL, EMBASE, Global Health Library, grey literature, and reference lists of relevant studies. Selection criteria Primary qualitative studies focusing on care occurring during labour, childbirth, and/or immediately postpartum in health facilities, without any restrictions on locations or publication date. Data collection and analysis A combined inductive and deductive approach was used to synthesise the data; the GRADE CERQual approach was used to assess the level of confidence in review findings. Main results Sixty‐seven studies from 32 countries met our inclusion criteria. Twelve domains of RMC were synthesised: being free from harm and mistreatment; maintaining privacy and confidentiality; preserving women's dignity; prospective provision of information and seeking of informed consent; ensuring continuous access to family and community support; enhancing quality of physical environment and resources; providing equitable maternity care; engaging with effective communication; respecting women's choices that strengthen their capabilities to give birth; availability of competent and motivated human resources; provision of efficient and effective care; and continuity of care. Globally, women's perspectives of what constitutes RMC are quite consistent. Conclusions This review presents an evidence‐based typology of RMC in health facilities globally, and demonstrates that the concept is broader than a reduction of disrespectful care or mistreatment of women during childbirth. Innovative approaches should be developed and tested to integrate RMC as a routine component of quality maternal and newborn care programmes. Tweetable abstract Understanding respectful maternity care – synthesis of evidence from 67 qualitative studies.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draft
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: SupervisionRole: Writing – original draft
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Writing – original draft
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Writing – original draft
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – original draft
                Role: ConceptualizationRole: MethodologyRole: ValidationRole: Writing – original draft
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: Writing – original draft
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – original draft
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                12 May 2020
                2020
                : 15
                : 5
                : e0233114
                Affiliations
                [1 ] Department of Midwifery Science, AVAG, Amsterdam Public Health research institute, Amsterdam UMC, VU medical centre, Amsterdam, The Netherlands
                [2 ] Department of Obstetrics, Amalia Children’s Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
                [3 ] Stichting Geboortebeweging (Birth Movement NL), Ede, The Netherlands
                [4 ] GGzE, Eindhoven, The Netherlands
                [5 ] Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
                [6 ] Hechte Band, Boxtel, The Netherlands
                [7 ] Department of Philosophy, University of Southampton, Southampton, United Kingdom
                [8 ] Department of Industrial Engineering & Innovation Sciences, Philosophy & Ethics, Technical University Eindhoven, Eindhoven, The Netherlands
                [9 ] Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, The Netherlands
                [10 ] Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
                Ravensburg-Weingarten University of Applied Sciences, GERMANY
                Author notes

                Competing Interests: We declare that the organizations Hechte Band and Geboortebeweging did not provide funding to carry out this study. Two authors (TL and RV) affiliated with these organizations were part of the research team representing the client. TL is a member of Geboortebeweging, a clinical psychologist and a PhD student (GGzE & Vrije Universiteit). RV is also a member of Geboortebeweging and is a certified babywearing consultant and bonding coach (Hechte Band). Both authors were involved in managing the #GG campaign in 2016, in which they also participated themselves. TL and RV were involved in the research process from the start. They provided feedback on the research proposal and design of the study and contributed to discussing the findings within the research team and writing the paper, all from a client point of view. They were not involved in data collection or analysing the data. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products to declare.

                Author information
                http://orcid.org/0000-0002-5291-5988
                Article
                PONE-D-19-33121
                10.1371/journal.pone.0233114
                7217465
                32396552
                60382406-e52f-4752-9154-9baaa7efa520
                © 2020 van der Pijl et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 29 November 2019
                : 28 April 2020
                Page count
                Figures: 2, Tables: 2, Pages: 21
                Funding
                The author(s) received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Birth
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Birth
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Birth
                Labor and Delivery
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Birth
                Labor and Delivery
                Social Sciences
                Sociology
                Communications
                Social Communication
                Social Media
                Computer and Information Sciences
                Network Analysis
                Social Networks
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                Social Sciences
                Sociology
                Social Networks
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                People and Places
                Population Groupings
                Ethnicities
                European People
                Dutch People
                Biology and Life Sciences
                Psychology
                Emotions
                Social Sciences
                Psychology
                Emotions
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Pregnancy
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Pregnancy
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Social Sciences
                Sociology
                Communications
                Social Communication
                Social Media
                Facebook
                Computer and Information Sciences
                Network Analysis
                Social Networks
                Social Media
                Facebook
                Social Sciences
                Sociology
                Social Networks
                Social Media
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                Custom metadata
                The data used in this study has been deposited to Zenodo and can be accessed via the following link: https://doi.org/10.5281/zenodo.3724213.

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