Upholding Rights Under COVID-19: The Respectful Maternity Care Charter
COVID-19 has exhausted hospitals and exposed deficiencies in the health system. With extreme efforts to suppress the virus, some maternal and child rights have been violated. And while it is common to have certain restrictions during health crises and emergencies, it is the right of every woman, baby, and family to have access to quality maternal newborn health (MNH) services.
Indeed, human rights are inalienable, and interdependent. In the event of a pandemic, these frameworks provide a solid legal and ethical basis for policies and practice. Solutions are being patterned to them as they promote optimal clinical practices to improve overall health while taking into account the freedom and liberty of the people.
According to the Respectful Maternity Care (RMC) Charter, the following are the universal rights of childbearing women: Every woman has (1) the right to be free from harm and ill treatment, (2) the right to information, informed consent and refusal, and respect for her choices and preferences, including companionship during maternity care, (3) the right to privacy and confidentiality, (4) the right to be treated with dignity and respect, (5) the right to equality, freedom from discrimination, and equitable care. (6) the right to healthcare and to the highest attainable level of health, (7) the right to liberty, autonomy, self-determination, and freedom from coercion.
In line with the COVID-19 restrictions, various violations to the mentioned rights were reported. This includes deficiencies in the health system, restricted access to care, alteration of practices, diminishing a woman’s decision making autonomy, potentially harmful medical interventions without the medical indication, and heightening gap in care inequities. The pandemic made apparent the insufficiency of resources in hospitals as there is lack of personal protective equipment, personnels, as well as bedspace in the maternity units. As a result, the availability of MNH services is limited. Maternal care is also inaccessible due to the unavailability of transport and fear of infection when going to the hospitals. There is also change in usual practices such as the mandatory separation of the mother and newborn as well as restriction to breastfeeding and companions during labor. Additionally, there is also an increase in cesarean sections and instrumental deliveries.
In response to this, the RMC Council has made suggestions on how to apply the rights of women and newborns during COVID-19. Among these are avoiding interventions that have no clear medical indication, giving safer alternatives for out-of-hospital birth, transition to digital health services, and keeping the mother and newborn together if neither of them requires intensive care, etc.
The COVID-19 crisis exposed the flaws within and outside health systems. However, it also provides the opportunity for critical analysis to strengthen and improve MNH care. In order to safeguard, maintain, and fulfill the rights of mothers and newborns while preventing the spread of infection require the cooperation of everyone to take part in their duties and responsibilities.
Reference:
Jolivet, R. R., Warren, C. E., Sripad, P., Ateva, E., Gausman, J., Mitchell, K., Hacker, H. P., Sacks, E., & Langer, A. (2020). Upholding Rights Under COVID-19: The Respectful Maternity Care Charter. Health and Human Rights, 22(1), 391–394. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7348430/#r8