Women are put through immense stress and vulnerability in times of pregnancy, especially during labor and delivery. In fact, 830 women die every day due to complications of pregnancy and childbirth and 99% of them occur in developing countries. Hence, it is of great importance that women are provided with quality, noble, and respectful care.
Respectful maternity care has been described as “a universal human right that encompasses the principles of ethics and respect for women’s feelings, dignity, choices, and preferences.” It aims to strengthen the interpersonal relationship between the mother and her health care providers across the stages of childbirth including labor, delivery, and postpartum. Furthermore, RMC also advocates for eradicating the abusive and ill behavior of health care providers and providing an encouraging and sensitive environment (Pratima & Bijaya, 2020). Generally, RMC consists of providing safe and timely care, fostering positive interactions with health care providers and women, protecting confidentiality, respecting privacy, obtaining consent, providing information, maintaining an active role in the labor process, and promoting freedom of choice (Hajian, Moridi, Pazandeh & Potrata, 2020).
A cohort study conducted by Hajizadeh, Meedya, and Vaezi among Iranian women demonstrated a strong positive correlation between high respectful maternity care and positive childbirth experience. However, growing evidence has shown that women around the world are experiencing abusive and disrespectful treatment during labor and childbirth which include physical abuse, non-consented clinical care, non-confidential care, non-dignified care, discrimination based on specific patient attributes, abandonment or denial of care, and detention in facilities. As a matter of fact, in West Zhewa Zone, only one-third of the mothers received RMC during their labor and childbirth at public health constitutions.
Skilled assistance during pregnancy and childbirth plays a significant role in decreasing maternal morbidity and mortality. However, disrespectful care of mothers results in poor health outcomes and reinforces mistrust of institutional care. This may lead to women delaying or avoiding care in health facilities, even at the risk of their health and their newborn (Bulto, Demissie & Tulu, 2020). In addition, some mothers would prefer to deliver at their homes to avoid discrimination and embarrassment in health facilities (Pratima & Bijaya, 2020). Furthermore, these traumatic memories of their childbearing experiences stay with them for a lifetime which can inflict lasting damage and emotional trauma (The White Ribbon Alliance, n.d.). These can result in several long-term negative effects such as poor mother-baby bond, unwillingness to breastfeed, PTSD, and poor quality of life. These can also affect the women’s reproductive health patterns such as sexual relationship, desire for a subsequent pregnancy, and making decisions regarding the type of childbirth undergone (Hajizadeh, Meedya, & Vaezi, 2020).
Therefore, it is vital that we take actions that would promote respectful maternity care. Health institutions must create awareness of health care providers on the standards of RMC. A qualitative study of Hajian, Moridi, Pazandeh, and Potrata on the midwives’ perspective of respectful maternity care revealed three emanating themes. First is showing empathy in which, the health care providers must build trust and confidence in women, use kind and respectful language, and understand the unique situations of the laboring women and their families. Second is the provision of a women-centered care which describes provision of evidence-based and harm-free care, elimination of unnecessary interventions without medical indication, provision of adequate intervention about procedures and interventions, recognizing women’s preferences and expectations, and involving women in decision-making. The third is protecting the women’s rights by respecting their privacy, confidentiality, equality, and provision of a comfortable, clean, and quiet labor and birth environment. In addition to this, policy makers should create solutions that would continuously monitor and reinforce accountability mechanisms for the health care providers in order to avoid mistreatments. Lastly, women must be informed and educated of their rights and maternity care principles.
References:
Bulto, G.A., Demissie, D.B. & Tulu, A.S. Respectful maternity care during labor and childbirth and associated factors among women who gave birth at health institutions in the West Shewa zone, Oromia region, Central Ethiopia. BMC Pregnancy Childbirth 20, 443 (2020). https://doi.org/10.1186/s12884-020-03135-z
Hajizadeh, K., Vaezi, M., Meedya, S. et al. Respectful maternity care and its relationship with childbirth experience in Iranian women: a prospective cohort study. BMC Pregnancy Childbirth 20, 468 (2020). https://doi.org/10.1186/s12884-020-03118-0
Moridi M, Pazandeh F, Hajian S, Potrata B (2020) Midwives’ perspectives of respectful maternity care during childbirth: A qualitative study. PLoS ONE 15(3): e0229941. https://doi.org/10.1371/journal.pone.0229941
Pratima Pathak, Bijaya Ghimire, "Perception of Women regarding Respectful Maternity Care during Facility-Based Childbirth", Obstetrics and Gynecology International, vol. 2020, Article ID 5142398, 8pages, 2020. https://doi.org/10.1155/2020/5142398
The White Ribbon Alliance (n.d.). Respectful Maternity Care: The Universal Rights of Childbearing Women. Who.int. Retrieved March 16, 2022 from https://www.who.int/woman_child_accountability/ierg/reports/2012_01S_Respectful_Maternity_Care_Charter_The_Universal_Rights_of_Childbearing_Women.pdf