Supportive community surrounding a pregnant woman, symbolizing respectful maternity care.

Beyond the Delivery Room: Why Respectful Maternity Care Matters

"New research reveals gaps in person-centered maternity care in low-income countries, highlighting the need for dignity and respect during childbirth."


Childbirth should be a moment of joy and empowerment, but for many women in low-income countries, it's marred by disrespect, abuse, and neglect within healthcare facilities. While skilled care during childbirth is critical for preventing maternal deaths, a new study reveals that quality care extends far beyond medical expertise. It emphasizes the urgent need for 'person-centered maternity care' (PCMC)—care that is respectful, responsive, and tailored to the individual needs and values of each woman.

Previous research has largely focused on documenting instances of mistreatment. This latest study, published in The Lancet Global Health, takes a broader approach by measuring PCMC across four different settings in Kenya, Ghana, and India. The findings paint a concerning picture: women are consistently missing out on essential elements of respectful and supportive care during childbirth, regardless of the setting.

This article explores the key findings of this important study, highlighting specific gaps in PCMC and what can be done to ensure that every woman experiences a safe and dignified childbirth.

What Does Disrespectful Maternity Care Look Like?

Supportive community surrounding a pregnant woman, symbolizing respectful maternity care.

The study, which involved over 3,600 women, used a validated scale to assess PCMC across three key domains: dignity and respect, communication and autonomy, and supportive care. While the average PCMC scores varied across the study sites, the lowest scores consistently fell within communication and autonomy. This suggests a systemic failure to involve women in decisions about their care and treat them with basic courtesy.

Specifically, the study revealed some alarming statistics:

  • Lack of Introduction: A staggering 90% of women across all countries reported that healthcare providers never introduced themselves.
  • No Permission for Procedures: In India, 73% of women said providers never asked permission before performing medical procedures.
  • Unexplained Procedures: Over 60% of women in Ghana and India reported that providers did not explain the purpose of examinations or procedures.
  • Medication Without Explanation: Nearly 60% of women in India were given medications without any explanation.
  • Inability to Ask Questions: Over half of women in Ghana felt unable to ask questions about their care.
  • Verbal and Physical Abuse: While less prevalent, 16% of women reported verbal abuse, and 3% reported physical abuse.
These findings highlight a critical breakdown in basic communication and respect for women's autonomy during childbirth. This not only undermines their dignity but can also have serious consequences for their health and well-being.

The Path Forward: Towards Respectful and Responsive Maternity Care

The study's authors emphasize that simply preventing abuse is not enough. True person-centered care requires a proactive approach to ensuring dignity, respect, and open communication throughout the childbirth process. This includes simple yet impactful steps such as introducing oneself, explaining procedures, and actively involving women in decision-making.

To create meaningful change, the researchers recommend:

Healthcare providers must be trained on the importance of PCMC, patient rights, and effective communication strategies. Clear measurement and accountability mechanisms are needed to reinforce PCMC practices. Ultimately, improving maternity care requires a comprehensive approach that strengthens healthcare systems and empowers women to demand respectful and responsive care.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/s2214-109x(18)30403-0, Alternate LINK

Title: Person-Centred Maternity Care In Low-Income And Middle-Income Countries: Analysis Of Data From Kenya, Ghana, And India

Subject: General Medicine

Journal: The Lancet Global Health

Publisher: Elsevier BV

Authors: Patience A Afulani, Beth Phillips, Raymond A Aborigo, Cheryl A Moyer

Published: 2019-01-01

Everything You Need To Know

1

Why is 'person-centered maternity care' (PCMC) considered so important during childbirth?

The study emphasizes the need for 'person-centered maternity care' (PCMC), which prioritizes respect, responsiveness, and individual needs. While medical expertise is crucial, PCMC acknowledges that quality care extends beyond it. It involves treating women with dignity, involving them in decisions, and ensuring open communication throughout the childbirth process.

2

What does disrespectful care look like in the context of maternity services, based on recent research?

Disrespectful maternity care, as highlighted by the study, encompasses several issues. This includes a lack of introduction by healthcare providers, performing procedures without asking permission, failing to explain the purpose of examinations or medications, creating an environment where women feel unable to ask questions, and instances of verbal or physical abuse. These actions compromise a woman's dignity and autonomy.

3

In which specific areas did the study find the most significant gaps in 'person-centered maternity care' (PCMC)?

The study revealed gaps in 'person-centered maternity care' (PCMC) across multiple countries. A significant finding was the consistent lack of communication and autonomy, with many women reporting that healthcare providers did not introduce themselves, seek permission for procedures, or explain the purpose of examinations or medications. These gaps were observed in Kenya, Ghana and India.

4

What are the potential long-term effects of not providing 'person-centered maternity care' (PCMC) to women during childbirth?

The implications of neglecting 'person-centered maternity care' (PCMC) are far-reaching. Beyond the immediate disrespect and violation of a woman's dignity, it can lead to negative health outcomes and erode trust in healthcare systems. When women feel unheard, uninformed, or mistreated, they may be less likely to seek care in the future, potentially increasing maternal mortality rates. Addressing PCMC involves systemic changes.

5

What practical steps can healthcare providers take to improve 'person-centered maternity care' (PCMC) and ensure a more positive childbirth experience?

To foster respectful and responsive maternity care, healthcare providers need to adopt a proactive approach centered on dignity and open communication. This involves simple but impactful actions such as introducing themselves, explaining procedures thoroughly, actively involving women in decision-making, and creating a supportive environment where questions are encouraged. Ultimately, the goal is to empower women during childbirth and promote positive experiences.

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