Respectful Care During Childbirth in Health Facilities Globally: A Qualitative Evidence Synthesis

This study sought to develop a conceptualization of respectful maternity care (RMC), since what constitutes RMC operationally in research and program implementation is often variable. The selection criteria was primary qualitative studies focusing on care occurring during labour, childbirth and/or immediate postpartum in health facilities without any restrictions on locations or publication date. Sixty-seven studies from 32 countries met our inclusion criteria. Twelve domains of RMC were synthesized: being free from harm and mistreatment; maintaining privacy and confidentiality; preserving women’s dignity; prospective provision of information and seeking of informed consent; ensuring continuous access to family and community support; enhancing quality of physical environment and resources; providing equitable maternity care; engaging with effective communication; respecting women’s choices that strengthen their capabilities to give birth; availability of competent and motivated human resources; provision of efficient and effective care; and continuity of care. Globally, women’s perspectives of what constitutes RMC are quite consistent. This review presents an evidence-based typology of RMC in health facilities globally, and demonstrates that the concept is broader than a reduction of disrespectful care or mistreatment of women during childbirth. Innovative approaches should be developed and tested to integrate RMC as a routine component of quality maternal and newborn care programs.