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Respectful Maternity Care : A Systematic Review.

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Respectful maternity care (RMC) frameworks are defined but vary. Measurement tools show consistency but need more evaluation for U.S. implementation. Evidence on RMC

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Area of Science:

  • Maternal Health
  • Public Health
  • Healthcare Quality

Background:

  • Severe maternal morbidity and mortality disproportionately affect Black women in the U.S. compared to similar nations.
  • Emerging evidence suggests disrespectful care during childbirth is a contributing factor to adverse maternal outcomes.
  • Understanding and implementing respectful maternity care (RMC) is crucial for improving maternal and infant health equity.

Approach:

  • Conducted a systematic review of English-language studies from inception to July 2023.
  • Searched multiple databases including Ovid Medline, CINAHL, Embase, and PsycInfo.
  • Included randomized controlled trials, nonrandomized studies, and qualitative validation studies.

Key Points:

  • Identified 12 RMC frameworks, with two main concepts: disrespect and abuse, and rights-based approaches.
  • Framework themes include freedom from abuse, consent, privacy, dignity, communication, safety, and justice.
  • Twelve RMC measurement tools were validated, but a lack of a gold standard limits criterion validity evaluation.

Conclusions:

  • RMC frameworks are described but definitions vary, impacting consistent measurement.
  • Validated RMC tools show internal consistency but require further evaluation for U.S. implementation.
  • Insufficient evidence exists on the effectiveness of RMC interventions for improving maternal or infant health outcomes.