Introduction: Disrespect and abuse during childbirth represents a pervasive issue worldwide. In Rwanda, however, research in this area remains scarce. This study evaluated the factors linked to disrespect and abuse during labor and delivery in two Rwandan district hospitals. Methods: Employing a mixed method, cross-sectional design, we studied 280 women giving birth at Kabutare and Kibagabaga hospitals. Analysis was conducted with SPSS version 22, using the Chi-square test to identify factors correlated with childbirth-related disrespect and abuse. Results: Our findings revealed that 27% of women reported verbal abuse and 27.5% reported abandonment by healthcare providers, with 12% experiencing physical abuse during childbirth. Factors increasing the likelihood of experiencing disrespect and abuse included residing in rural areas [AOR=4.06, 95% CI (1.12, 14.7); p=0.03], having only primary education [AOR=2.9, 95% CI: 1.10-8.9, p=0.04], and night-time delivery [AOR=2.23, 95% CI (1.34, 3.03); p=0.03]. However, having a cesarean delivery [AOR=0.23, 95% CI: 0.09-0.59, p=0.002] or having attended antenatal care [AOR=0.28, 95% CI: 0.13-0.81, p=0.029] significantly reduced the risk of such experiences. Conclusion: The study uncovers a high incidence of disrespect and abuse during labor and delivery in Rwanda. The identified risk factors, namely rural residence, lower education, and night-time delivery, highlight specific areas requiring targeted intervention. The results advocate for effective measures to ensure dignified and equitable maternity care for all women.

Background: Labor companionship has been demonstrated to enhance the childbirth experience and contribute to better maternal and neonatal outcomes. Despite this evidence, the practice remains underexplored in Rwanda. The present study aimed to investigate the perspectives and experiences of both women and healthcare providers concerning labor companionship in selected hospitals across Rwanda. Methods: We conducted a mixed-method study surveying 393 postpartum mothers within 48 hours of delivery and interviewing 23 healthcare providers and 16 mothers. Data were analyzed using frequencies, percentages, Chi-square tests, and logistic regression. Results: 95% (n=373) of mothers brought a chosen companion to the health facility, but only 11.2% (n=42) were allowed their companion’s presence during childbirth. About 47% who had companions present had reservations, mainly due to embarrassment (47%), gossip fears (14%), and privacy issues (40%). Mother’s age, education, economic status, and pregnancy planning status influenced companion presence. Barriers to labor companionship occurred at individual, provider, and institutional levels. Conclusion: This study underscores labor companionship’s role in boosting maternal-neonatal health in Rwanda, though implementation remains limited due to location, education, and socio-economic disparities. It advocates for policies and guidelines facilitating companionship during labor and delivery and emphasizes the need for healthcare provider training to enhance its application.