Respectful Maternity Care is Everyone's Responsibility
Respectful Maternity Care paves the way for women to have a safe pregnancy. Women first-hand experience abuse and disrespect which may be a contributing factor to them not prioritizing their care during pregnancy. It is possible that when they experience abuse, shame, and neglect, in the hospitals or health centers, they may not return anymore to receive the care, especially antenatal care, that they need. This may increase the risk for both pregnancy-related mortality and morbidity. In addition, it is also a possibility that she and her child remain at risk even during and after delivery because of poor care. Abuse may occur in all societies but is much more common in low- and middle-income countries such as the Philippines. Abuse can appear in all forms such as:
-
Physical or verbal abuse or humiliation
-
Non Confidential Care
-
Detainment because of unpaid medical fees
-
Abandonment of Care
-
Denial of Access to A Health Facility
-
Discrimination
It is also important to see that abuse and mistreatment does not just focus on verbal, physical, or emotional abuse but it may also be in the system itself which serves as underlying factors. According to USAID (2012), factors may range from national or institutional policies, to the lack of adequate infrastructure and equipment, to a lack of human resources. National policies may include the lack of regulations or failure to implement or enforce laws and policies. Lack of infrastructure and poor working conditions may also be a significant cause. Lastly, human resources such as inadequate staffing, shortage of health workers, and underpaid staff may also be another cause. When complications arise, it is possible that they will not prioritize going to the health facility to get the appropriate treatment. Rather, they would be more inclined to receive alternative treatments or unsafe treatments which may pose more risks than benefits. Most importantly, they may not be able to recognize signs of emergency especially when needed. Improving access to health facilities will not be able to save women if the women themselves are not willing or allowed permission to travel to facilities as well as those who possibly receive abuse if they do.
Health systems must be able to prioritize and implement respectful maternity care practices and the rights of both clients and health workers. Those in the health field including women and families must be able to know and understand the rights of a woman in maternity care. Some of the most common interventions that were done to address Respectful Maternity Care include:
-
Strength Training
-
Implementing quality improvement approaches
-
Developing clinical guidelines and protocols
-
Implementing community activities, including campaigns
-
Strengthening local laws and regulations
-
Advocacy, including initiatives and clients’ right charter
-
Supporting women who want to give birth
-
Professionalizing midwifery in order for them to have autonomy as primary care providers together with women and their families.
As a nurse, it is important to understand that even if these conditions exist, especially in the current situation of the country, we do not use it as an excuse to disrespect and abuse patients. It is essential that we create an environment of care, especially since nursing as a profession prioritizes care. We should be able to treat our future patients with respect and ensure that they feel safe. It is most likely that the woman who is visiting the health center for prenatal care or check-ups is scared and anxious, especially first time mothers or those who have complications. They may not know what to expect during their appointment, which may lead them to ask questions or even be anxious about the assessment. With our knowledge on this, we must maintain proper nurse-patient communication and establish proper connection and rappor with the patient.
Now, as a student-nurse, as I am still studying all the concepts that I need to apply in the future, I recognize that I should also start practicing respectful care and communication. I should not merely focus on the treatment plan and the skills of being a nurse, rather, it is also essential to focus on the therapeutic communication between my future patients and I. This is so as early as now, I may be able to build my foundation on this aspect, and may apply respectful communication and respectful maternal care no matter what situation I am in.
References:
Bartlett, R. (2015). Respectful maternity care is everyone’s responsibility. https://www.intrahealth.org/vital/respectful-maternity-care-everyone%E2%80%99s-responsibility
USAID. (2012). Respectful maternity care. https://toolkits.knowledgesuccess.org/sites/default/files/rmc_survey_report_0_0.pdf