Table 2 PID 103—clinic birth—case analysis

In describing her birth experience, the participant provides a detailed account of her baby’s birth. At the beginning of her labor, she describes the nurses being “fast asleep.” As her labor progressed, she could feel the baby was coming, and called for the nurse. When attending to her, the nurse “told me there was no baby coming and instructed me to step down from the bed (to keep walking).” Following the nurse’s instructions, the participant stepped off the bed, and leaked mucous or fluids on the floor. The participant describes the ensuing interaction with the nurse as follows:

“The nurse who instructed me to step down from the bed shouted at me wanted the reason for giving birth (likely mucous or fluids) on the floor. I replied to her that she is the one who instructed me to step down from the bed and I had to follow her instructions as I was afraid of her. The floor was dirty, and she gave me something to clean the floor. […] She said, ‘I can’t work on a dirty area; you must clean the floor because there are no cleaners over the night.’ I started to clean, and I could still feel that my baby was coming.”

The participant explained that her baby was not born yet when she was cleaning the floor, but “her head was out already.” She described being afraid of the nurse and feeling that she had to follow the nurse’s instructions, even though the baby was coming. She goes on to say:

“I started by cleaning where the nurse was going to walk pass[ed] and my water broke (likely mucous or fluids) while I was busy cleaning.”

The participant says, “I ended up giving birth to my baby while I was standing on the floor.” She describes the birth as follows:

“…a nurse instructed me to catch my baby. She [the nurse] said, ‘Who has to catch your baby if you don’t?’ […] The ward was dirty by then. She said, ‘What must I do and how could I attend to you when the ward is dirty like this?’ I said, ‘I told you from the beginning that my baby is coming; you were supposed to attend to me long time ago’ She said, ‘Stay there; I will take your baby and I will leave you dirty like that until I have time to attend to you’. I ended up asking what I have done to her; maybe she knows me, and I don’t know her. She said, ‘You have never done anything to me; do you think I treat you different from other patients?’ I said ‘It is obvious that you treat us all like this’. That’s how it went.”

Reflecting on her experience, this participant states: “…I heard that the staff in there [at the healthcare facility] mistreats their patients. I never took what I heard serious; I wanted to experience it. I believed what I heard after I had such a bad experience.”

She went on to say: “[I will] never come to [hospital name] again” after having negative experiences. “I might as well have done everything at home because there was no need for me to go to the hospital if I could do it on my own whereas there are people who were hired to take care of us.”

Harm and ill-treatment:

The participant describes receiving no help or assistance when she felt her baby was coming, or when her baby was crowning (“her head was out already”)

The participant describes being implicitly threatened, in that she must clean the floor to access care from the nurse. The participant describes the fear she felt when she decided to follow the nurse’s instructions

When her baby was born, the participant had to catch her own baby to prevent the baby from falling on the floor, despite the presence of the nurse

Information and informed consent:

When describing her child being removed from her, the participant does not indicate that she consented to this procedure. The participant described the nurse as forcefully removing her baby and leaving the participant dirty and unattended

Dignity and respect:

The participant describes several instances of disrespect, including being ignored when she tells the nurse her baby is coming, shouted at for leaking fluids on the floor, and being told to clean the floor while in labor

Equitable care:

During her interaction, the participant describes asking the nurse why she is being treated so poorly. According to the participant, the nurse says that she treats all patients the same, in that all birthing women are treated disrespectfully by the nurse

Access to healthcare:

The participant is denied access to care due to the “dirty area,” and is seemingly punished for leaking fluids during her labor

Ultimately, the participant describes a desire to avoid the hospital in the future, because of the poor level of care provided during her birth

Child separation

The participant describes the nurse removing her baby while she is distressed, causing the participant to ask why the nurse is treating her so badly. As the participant describes it, the baby was removed without consent