I came across this relevant article entitled "Respectful maternity care in the context of COVID-19: A human rights perspective" when exploring the internet for information regarding Respectful Maternity Care. Before getting into the main point of the article, I'd like to share WHO's definition of respectful maternity care, which is defined as "care organized for and provided to all women in a manner that maintains their dignity, privacy, and confidentiality, ensures freedom from harm and mistreatment, and enables informed choice and continuous support during labor and childbirth," as cited in the article. Respectful maternity care, according to this definition, focuses on the mother's safety, particularly during labor and delivery. Returning to the article's core topic, which was chosen with the goal of providing respectful maternity care, as indicated earlier, this issue caught my attention since, in addition to being timely, it is also very controversial. Reingold, Barbosa, and Mishori (2020) examine two primary themes in this article: (1) recent changes in maternity care, and (2) the implications of these changes to human rights.
The COVID-19 pandemic has caused recent changes in maternity care, primarily with alternative approaches to prenatal care, such as reducing the number of patient in-person visits, switching to telehealth for the majority of prenatal visits, restrictions against having a companion present during labor and delivery, performing certain medical interventions, particularly for women who were positive for SARS-CoV-2 during labor and delivery (i.e., induction of labor, instrumental deliveries, and cesarean deliveries), and in the context of postpartum care, they temporarily separated newborns from women who tested positive for SARS-CoV-2 (discouraging skin-to-skin contact and limiting breastfeeding). These adjustments may have been intended to limit viral transmission among pregnant women and health professionals, but it cannot be denied that they also had various adverse implications that violated pregnant women's human rights. Switching to telehealth, for example, is a distinctly anti-poverty move. People who do not have access to or use of remote communications technology, such as those who live in places with limited internet connection, those who are poor and don't have access to gadgets, and those with low technological knowledge, will be disadvantaged by this shift.
In addition to the changes mentioned above, it was also included in the article that the COVID-19 pandemic has exacerbated a number of harmful practices already prevalent in the setting of prenatal, intrapartum, and postpartum care, including lack of knowledge, denial or suspension of treatment, neglect, abandonment, and abuse.Women have reported obtaining minimal or inadequate information regarding policies, interventions, referrals, and the entire range of alternatives accessible to them, according to the study. They've also been denied emergency treatment outright, as well as limited access to emergency transportation, out-of-hospital choices for expert care, pain management, and a variety of intrapartum and postpartum support programs. These situations are indications of violations of human rights, which form the normative basis of the respectful maternity care framework. Given the unseen and interwoven character of human rights, they affect not just on people's right to health, but also on their rights to knowledge, non-discrimination, the advantages of scientific development, and participation.
Based on the two reasons outlined in the article, I came to the conclusion that the COVID-19 pandemic has indeed caused various changes in maternal health that are affecting pregnant women indirectly. I believe that such regulations or adjustments were presented in order to decrease COVID-19 cases, however they may have neglected the harmful effects on pregnant women's overall health status, particularly in terms of their entitlement to respectful maternity care regardless of the circumstances.
References: Reingold, R. B., Barbosa, I., & Mishori, R. (2020). Respectful maternity care in the context of COVID‐19: A human rights perspective. International Journal of Gynecology & Obstetrics, 151(3), 319–321. https://doi.org/10.1002/ijgo.13376