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A Capacity-Building, Multisite, Quality Improvement Project Aimed at Respectful Maternity Care
Nursing for Women'S Health
|June 1, 2026
Summary
An evidence-based respectful maternity care program improved nurses' attitudes and beliefs about childbirth. Barriers included institutional constraints, but peer support and autonomy facilitated positive shifts in care.
Area of Science:
- Nursing Education and Practice
- Maternity Care Quality Improvement
- Evidence-Based Healthcare Delivery
Background:
- Respectful maternity care is crucial for positive childbirth experiences.
- Nurses' attitudes and beliefs significantly influence care practices.
- Implementing evidence-based programs requires understanding facilitators and barriers.
Purpose of the Study:
- Evaluate the impact of an evidence-based respectful maternity care program on nurses' attitudes and beliefs.
- Assess maternal perceptions of care.
- Identify facilitators and barriers to program adoption in U.S. hospital units.
Main Methods:
- Utilized a Plan-Do-Study-Act framework with a pretest-posttest design.
- Intervention: Association of Women's Health, Obstetric and Neonatal Nurses Respectful Maternity Care Framework.
- Collected quantitative (Nurse Attitudes and Beliefs Questionnaire) and qualitative (focus groups, patient surveys) data from 9 U.S. maternity units.
Main Results:
- Significant improvement in nurses' attitudes and beliefs scores post-intervention (p = .008).
- Barriers identified: institutional constraints, hierarchies, lack of training time.
- Facilitators identified: peer support, autonomy, commitment to humanized care; no significant change in patient perspectives.
Conclusions:
- Evidence-based respectful maternity care programs can positively shift nurses' attitudes and beliefs.
- Local culture, interdisciplinary alignment, and reflection opportunities support attitude shifts.
- Program adoption is influenced by overcoming institutional barriers and leveraging supportive factors.
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