Nègènègèn: Sweet talk, disrespect, and abuse among rural auxiliary midwives in Mali

Nicole Warren; Madeleine Beebe; Rachel P Chase; Seydou Doumbia; Peter J Winch

doi:10.1016/j.midw.2015.07.007

Nègènègèn: Sweet talk, disrespect, and abuse among rural auxiliary midwives in Mali

Midwifery. 2015 Nov;31(11):1073-80. doi: 10.1016/j.midw.2015.07.007. Epub 2015 Jul 30.

Authors

Nicole Warren¹, Madeleine Beebe², Rachel P Chase³, Seydou Doumbia⁴, Peter J Winch⁵

Affiliations

¹ Johns Hopkins University, School of Nursing, Department Community-Public Health, 615 North Wolfe Street, Baltimore, MD 21205, United States. Electronic address: nwarren3@jhu.edu.
² Johns Hopkins University, Bloomberg School of Public Health, Department of International Health, 615 North Wolfe Street, Baltimore, MD 21205, United States. Electronic address: mbeebe@jhu.edu.
³ Johns Hopkins University, Bloomberg School of Public Health, Department of International Health, 615 North Wolfe Street, Baltimore, MD 21205, United States. Electronic address: Rachel.p.chase@gmail.com.
⁴ Department of Public Health, Université des Sciences, des Techniques et des Technologies de Bamako, Mali. Electronic address: sdoumbi@icermali.org.
⁵ Johns Hopkins University, Bloomberg School of Public Health, Department of International Health, 615 North Wolfe Street, Baltimore, MD 21205, United States. Electronic address: pwinch@jhu.edu.

PMID: 26299369
DOI: 10.1016/j.midw.2015.07.007

Abstract

Objective: the purpose of this study was to explore disrespect and abuse toward women in labor from the perspective of auxiliary midwives.

Design: this study uses a cross-sectional, descriptive mixed-methods design using surveys and interviews.

Setting: Koutiala, Mali.

Participants: 67 mostly rural auxiliary midwives.

Interventions: this was a descriptive study and had no intervention component. The variables of interest were Malian auxiliary midwives' reports of caring and respectful, as well as abusive and disrespectful, behaviours towards childbearing women.

Findings: participants reported abusive and disrespectful behaviour toward women, particularly yelling, insulting, and displaying a hostile or aggressive attitude. However, auxiliary midwives also stressed the importance of making women feel welcome and comfortable, sweet-talking to them throughout labor, and providing quality care. IMPLICATIONS FOR TRAINING AND PRACTICE: we recommend a strengths-based approach to pre-service and continuing education to ensure that auxiliary midwives meet the basic competencies for midwives and appreciate both the impact of their abusive and disrespectful behaviours and the value of the respectful care they already provide.

Keywords: Attitude of health personnel; Maternal health services; Midwifery; Pregnancy/childbirth/parturition; Professional–patient relations; Respect in pregnancy.

MeSH terms

Attitude of Health Personnel*
Female
Humans
Labor, Obstetric
Mali
Maternal Health Services / standards*
Midwifery*
Pregnancy
Professional-Patient Relations*
Quality of Health Care
Rural Health Services
Surveys and Questionnaires