Background: Healthcare coverage in Ethiopia has improved dramatically in recent decades. However, facility-based delivery remains persistently low, while maternal mortality remains high. This paper presented the prevalence and associated factors of disrespect and abuse during childbirth in public health facilities of western Oromia, Ethiopia.

Method: A facility-based cross-sectional study was conducted among 612 women from February 2017 to May 2017. Exit interview of the mothers was conducted upon discharge from the maternity ward. We measured disrespect and abuse during childbirth using seven dimensions. Multivariate logistic regression models were used to assess the association between the dependent variable and client and institutional factors.

Result: Three fourth (74.8%) women reported experiencing at least one form of disrespect and abuse. The proportion of disrespect and abuse categories experienced by the women were physical abuse (37.1%), non-dignified care (34.6%), non-consented care (54.1%), non-confidential care (40.4%), neglect (25.2%), detention (2.9%), and discrimination (13.2%). Experiences of disrespect and abuse were 1.6 times more likely to be reported by women delivering at hospitals than health centers (OR: 1.64, 95% CI: 1.01, 2.66). Women who gave birth to their first child than who have three and above (OR: 1.9, 95% CI: 1.14, 3.33), Women lacking companion throughout delivery than women who had a companion (OR: 9.94, 95% CI: 5.72, 17.28) were more likely to encounter disrespect and abuse. On the other hand, women with more than 1,368-birr (USD 57) monthly income were less likely to experience any type of disrespect and abuse (OR: 0.36, 95% CI: .21, .65).

Conclusion: Three in four women reported experiencing at least one form of disrespect and abuse during labor and delivery. This demonstrates a real disconnect between what the health system intends to achieve and calls for fundamental solutions in terms of both improving qualities of facility-based delivery and ensuring women’s right to receive health care with dignity.

Keywords: Facility-based delivery, Disrespect and abuse, Maternal mortality, Quality of care, Western Oromia, Ethiopia