The moment we treat women and mothers as subservient beings who should always follow our demands and instructions just because we are healthcare professionals, that is the same time we lose our credibility as care providers.
Respectful Maternity Care emphasizes the fundamental rights of women, newborns, and families, and that promotes equitable access to evidence-based care while recognizing the unique needs and preferences of both women and newborns (Shakibazadeh et al., 2017). This is one of the most crucial elements of care that must be employed in caring for pregnant mothers. However, despite the amount of research and understanding we have over the importance of RMC, we still have a long way to go to make sure that this kind of care is experienced by all women across the globe.
According to the World Health Organization (2019), about 830 women every day die from preventable causes related to pregnancy and childbirth. What’s concerning about this is that a huge portion of these deaths originate from low and lower-middle-income countries such as sub-Saharan Africa in which only about 52% of women have access to skilled attendance at birth. This is harmful because it creates a huge burden for the healthcare sector to serve and meet the increasing demand for maternal service.
And I think this is where the problem comes in. Because of this huge burden and responsibility imposed by the failed system towards our healthcare workers they become the target and sole enemy of disrespectful maternity care without actually analyzing the systemic issues and atrocities that drive them to act in a certain way.
To further analyze this, we have to look at it from two perspectives, one is from the cultural perspective and the second is in terms of state failure and systematic oppression.
First is in terms of culture, we have to understand that in developing countries particularly in sub-Saharan Africa there is a huge gap between the rich and poor. But more than this, it is also evident that most of the healthcare professionals in high-resource facilities belong to the middle to the upper class. Because of this power imbalance both from social status and educational attainment between the healthcare workers and patients, the tendency to control and exert power over a women's bodies and knowledge is higher (Bradley et al., 2016). This is bad because what happens to pregnant women who visit hospitals for maternity care loses a sense of agency, dignity, respect, and privacy due to the healthcare professionals’ exertion of dominance and power.
The second thing I want to discuss is in terms of state failure and systematic oppression. We have to take note that these poorer regions of the globe were once colonized and taken advantage of by the western countries. Because of this, the capacity of these nations to rebuild their economy and provide better health services to their citizens is very minimal and weak. This can then translate to chronic staff shortages, lack of resources, and inadequate supervision and support to the health sector which makes it more difficult for them to work and provide better services (Chen et al., 2004).
In the end, what this only proves is that the issue when it comes to Respectful Maternity Care is more inherent and systemic which is not easily solvable by encouraging our nurses, midwives, or doctors to be good, but rather this far extends to the driving factors and trends that motivate them to act into certain ways. However, what we can do at this point as healthcare students is to continuously advocate for respectful maternity care while at the same time recognizing the root causes of such unjust and unfair treatment of society towards not only women and children, but as well as to the healthcare professionals themselves.
REFERENCES:
Bradley, S., McCourt, C., Rayment, J., & Parmar, D. (2016, November). Disrespectful intrapartum care during facility-based delivery in sub-Saharan Africa: A qualitative systematic review and thematic synthesis of women's perceptions and experiences. https://www.sciencedirect.com/science/article/pii/S0277953616305469.
Chen, L. et al. (2004, November). Human resources for health: overcoming the crisis. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)17482-5/fulltext.
Maternal Health Task Force. (2014, December 13). Respectful Maternity Care. Maternal Health Task Force. https://www.mhtf.org/topics/respectful-maternity-care/.
Roser, M. & Ritchie, H. (2013). Maternal Mortality. https://ourworldindata.org/maternal-mortality#citation.
Shakibazadeh, E., Namadian, M. & Bohrenl, MA. (2017, November 8). Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.15015.
World Health Organization. (2019, September 19). Maternal Mortality. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality.