Respectful maternity care in Indonesia: A factor analysis with a multicenter study approach

Respectful Maternity Care (RMC) is an international interest that relates to the ethical, psychological and cultural aspects of childbirth. Indonesia has not fully implemented this, women still do not have the power over their own bodies. Medical interventions during childbirth also dominate, such as cesarean birth and episiostomy in vaginal birth. This study aims to analyse RMC and the factors that influence it in referral hospitals.

A multi-centre institution-based cross-sectional study design. The population of this study were late second trimester (26-27 weeks) and early third trimester (28-30 weeks) pregnant women who checked their pregnancy at one of the referral hospitals in this study, which were selected using a simple random sampling technique. Analysis used a linear regression approach to determine the influential variables (p ≤ 0.05). Significance testing used multiple linear regression analysis.

There were 6 variables that influenced the RMC score, including method of childbirth, prolonged labour, postpartum hemorrhage (PPH), repeated vaginal examination, episiostomy and choice of childbirth position. These six factors had an influence power on RMC of 44.1 %.

Medical interventions (cesarean delivery, episiostomy) and excessive invasive measures (repeated vaginal examination) negatively affect RMC scores. This should be a reflection for Indonesia to promote women-centered care that protects women's rights to their bodies. Thus, women who suffer from complications such as postpartum hemorrhage and prolonged labour can still have a good birth experience.