Respectful Maternity Care: Exploring Gaps and Opportunities to Improve Birthing Experiences

Respectful maternity care is an important factor in addressing maternal health outcomes; however, stark differences persist among maternal populations. Examining respectful maternity care experiences of postpartum individuals can inform strategies to address gaps in healthcare delivery and outcomes. This study explores postpartum individuals' experiences with respectful maternity care and identifies gaps in maternity care delivery in Florida.

This qualitative study used thematic analysis of semi-structured in-depth interviews conducted via videoconferencing or telephone from June 26 to August 25, 2023. Participants were recruited from Healthy Start Coalitions across Florida. Participants included 163 postpartum individuals from diverse backgrounds who were at least 18 years old, spoke English, Spanish, or Haitian Creole, and had given birth in Florida within the last year. The primary outcomes were participants' overall scores of their birth experience and described experiences of respectful maternity care. Key themes related to respectful maternity care during the birthing hospital stay were identified.

Participants from 37 counties had given birth in one of 42 hospitals. On average, participants were 2.8 months postpartum, with a mean age of 29.5 years, and were racially and ethnically diverse-35.6% Black/AA, 32.5% Hispanic, and 31.3% White. Participants rated their overall hospital birth experience an average of 8.8 out of 10, indicating a very good experience. Four major themes emerged, highlighting gaps and differences in respectful maternity care: (1) discrimination (racial discrimination, age, race, and socioeconomic status, and immigration status); (2) consent (provision of comprehensive health-related information to consent, and lack of consent in patient's primary language); (3) patient-provider communication (consistency, adequacy, and clarity of information given by healthcare providers, active listening and interactional tone, and language barriers); and (4) respect for patients' choices (engagement in shared decision-making, provision of sufficient pain management, and provision of comprehensive lactation support).

This study identified discrepancies in respectful maternity care experiences among postpartum individuals, emphasizing the need to address these gaps. Findings support the development and implementation of quality improvement interventions targeted at improving respectful maternity care to ensure high-quality, patient-centered maternity care for all patients.