Experiences of maternity care (MC): Perspectives among women, partners and service providers in Trinidad

Abstract

Purpose

Despite the growing global literature around Respectful Maternal and Newborn Care (RMNC), there has been limited information on reducing mistreatment and promoting RMNC in the Latin American and Caribbean (LAC) region. This formative study conducted in Trinidad and Tobago aimed to describe the current experiences of maternity care in the public and private sectors from the perspectives of women, their male partners, service providers and managers/administrators.

Principal results

Nested in a wider mixed methods study undertaken in four of five regions in Trinidad and Tobago, this paper focuses on qualitative findings from 45 interviews, six focus groups (n = 54) and insights from a co-design workshop to contextualize findings. We found that experiences of care sit along a continuum of respectful care to mistreatment, centering around five broad themes: 1) communication with healthcare staff, 2) judgment and/or discrimination; 3) decision-making and autonomy; 4) partner involvement; and 5) privacy and confidentiality. While open communication, enabling environments, birth planning, partner support and safeguarding personal information determined RMNC; non-verbal cues, provider preconceptions, and tensions between extant policy and practice led to experiences of mistreatment. Complexities identified across often convergent perspectives require broader systems solutions.

Major conclusions

This study expands the learning on women’s experience of childbirth by triangulating perceptions of women, their partners, health workers, and policymakers. Addressing mistreatment of both women and health workers and strengthening RMNC in Trinidad and Tobago and similar settings requires moving beyond interpersonal provider-client interactions to a culturally sensitive, multi-component, health systems approach.