Safe maternal and child care goes beyond the prevention of morbidity and mortality. It encompasses respectful maternity care and access to the highest attainable standard of care, thereby making it a fundamental universal human right. It enables women to have control, to feel included, and to safeguard their dignity in order to optimize access to and use of available health services. Unfortunately, in reality, this is not what women often experience. Evidence suggests that the fear of disrespect and abuse women encounter in health facilities due to lack of respectful maternity care is a “more powerful deterrent to use of skilled care in countries with a high burden of maternal mortality than commonly recognized barriers such as cost or distance” (Futures Group Global, n.d.).
In a 2010 landscape analysis, Bowser and Hill described seven major categories of disrespect and abuse that childbearing women encounter during maternity care and childbirth. A 2015 systematic review updated this framework as follows: physical abuse, sexual abuse, verbal abuse, stigma and discrimination, failure to meet professional standards of care, poor rapport between women and providers, and health system conditions and constraints (Maternal Health Task Force, 2020).
Women’s childbearing experience can either be empowering and comforting or damaging and traumatic. Either way, it lasts throughout their lifetime. Disrespectful maternity care is a key factor that contributes to why many women do not choose to access health facilities for care during childbirth.Prevention and elimination of disrespectful maternity care calls for the mobilization of governments, researchers, and local communities to advocate for RMC. While a number of interventions aim to address this issue and improve access to skilled birth care, less attention has been placed on the quality of relationships with caregivers during maternity care and many women worldwide continue to experience aspects of disrespectful and abusive care during childbirth. Focusing on quality RMC remains critical for improving global maternal health as facility-based birth and the number of skilled birth attendants are steadily rising.
According to Moridi et al. (2020), components of RMC during labor and birth from the healthcare providers’ perspectives generally include “providing safe and timely care, nurturing positive interactions between midwives and women, protecting confidentiality, maintaining an active role in the labor process, obtaining the women’s consent before performing procedures, providing information regarding procedures to women, respecting patient privacy, and promoting freedom of choice as it related to position for labor and birth.” Meanwhile, from women’s perspectives, a vital component in improving quality of care and patient satisfaction is the healthcare provider’s respectful behavior which makes it a critical indicator of maternal health care.
References:
Futures Group Global. (n.d.). Respectful Maternity Care. The Health Policy Project. http://www.healthpolicyproject.com/index.cfm?ID=topics-RMC
Maternal Health Task Force. (2020, May 20). Respectful Maternity Care. https://www.mhtf.org/topics/respectful-maternity-care/
Moridi, M., Pazandeh, F., Hajian, S., & Potrata, B. (2020). Midwives’ perspectives of respectful maternity care during childbirth: A qualitative study. PLOS ONE, 15(3). https://doi.org/10.1371/journal.pone.0229941
The White Ribbon Alliance for Safe Motherhood. (n.d.). Respectful Maternity Care. Safe Motherhood For All. https://www.safemotherhoodforall.org.au/position-statements/respectful-maternity/#:%7E:text=The%20White%20Ribbon%20Alliance%20for,from%20harm%20and%20ill%20treatment