The WHO strongly recommends respectful maternity care to all women and they defined it as a care that was organized for and provided to all women in such a manner that will maintain women’s dignity, privacy and confidentiality. This care also ensures that women have freedom from harm and mistreatment, and enables informed choice and continuous support during labor and childbirth. By the strict accordance of respectful maternity care to basic human rights, this will help women in order for them to have better and improved experience in labor, childbirth, as well as addressing the existing health inequalities.
In the qualitative evidence synthesis of Shakibazadeh et. al. (2017), they formulated twelve domains of respectful maternity care in the perspective of health care providers and women. These are the following 1) Being free from harm and mistreatment 2) Maintaining privacy and confidentiality 3) Preserving women’s dignity 4) Prospective provision of information and seeking informed consent 5) Ensuring continuous access to family and community support 6) Enhancing quality of physical environment and resources 7) Providing equitable maternity care 8) Engaging with effective communication 9) Respecting women’s choices that strengthens their capabilities to give birth 10) Availability of competent and motivated human resources 11) Provision of efficient and effective care and 12) Continuity of care
The importance of these domains of respectful maternity care has a positive correlation to women’s childbirth experiences because it gives them a sense of security, safety, care, respect and autonomy especially in decision making together with their healthcare providers. On the other hand, if women experience disrespectful care, there is a high chance that they will refrain from seeking facility based maternal health services and might cause adverse effects when they deliver their baby.
There have also been studies that determine evidence on how to improve respectful maternity care although still limited. With the help of the WHO they have identified interventions that were multi-component. The good thing about this is that it shows inclusivity of community engagement and quality improvement for providers. Some of these components are the ff: Training in values and transforming attitudes, Training in interpersonal communication skills, Setting up quality improvement teams, Monitoring experiences of mistreatment, Mentorship for healthcare providers, Improving privacy in maternity wards, Improving working conditions for staff, Hosting maternity open days ·, Mediation/alternative dispute resolution, Counseling of community members who experienced mistreatment during childbirth, Improving accountability by setting up complaint mechanisms and Educating women and girls about their rights (Downe, et. al., 2018)
In order for a respectful maternity care to be successful ofcourse it should be supported and well funded by the government especially given importance by our Department of Health. Thus there should be health policy and considerations of different systems. According to WHO (2018) there are different resources that a country should focus on in structuring health policies and environments to provide respectful maternity care. This includes strengthening policies, training of healthcare providers, adequacy of staffs, supplies, equipments, and infrastructure and of course the constant supervision, monitoring and evaluation.
However, in any type of care there were problems and challenges that it faces especially now we are still in the Covid 19 Pandemic. Jolivet et. al. (2020) cited the report of RMC Global Council about violations in some aspects of respectful maternity care that was observed during the height of the pandemic and these including the ff: exacerbated deficiencies in overwhelmed health systems, neglect, abandonment, restricted access to care, alteration of proven practices without evidence, acts curtailing women’s decision-making autonomy, potentially harmful medical intervention without indication, and exacerbation of care inequities.
In conclusion, the provision of sufficient, cost effective, and inclusive maternal care is monumental to reproductive aged women especially those who are part of the marginalized sector in our country. It only shows that the government should focus on improving certains aspects of healthcare in order for this group of people to feel they are valued and given importance as giving birth is considered as an important rite of passage that is already embedded in our rich cultural heritage as Filipinos. And as future health care professionals, it is also our role to be an advocate, implementer, and facilitator of respectful maternity care that every Filipino woman deserves to experience as part of the basic human rights.
References:
Downe, S., Lawrie, T. A., Finlayson, K. and Oladapo, O. T. (2018). Effectiveness of respectful care policies for women using routine intrapartum services: a systematic review. Reprod Health; 15(1): 23.
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.
Shakibazadeh, E., Namadian, M., Bohren, M. A., Vogel, J. P., Rashidian, A., Pileggi, V. N., et al. (2017). Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis. BJOG .
World Health Organization. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience. Geneva, Switzerland. Reetrieved March 16, 2022 from https://www.who.int/reproductivehealth/publications/intrapartum-care-guidelines/en/