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BJOG. 2018 Jul;125(8):932-942. doi: 10.1111/1471-0528.15015. Epub 2017 Dec 8.

Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis.

Author information

1
Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
2
Social Determinants of Health Research Centre, Zanjan University of Medical Sciences, Zanjan, Iran.
3
Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland.
4
Department of Information, Evidence and Research, Eastern Mediterranean Region, World Health Organization, Cairo, Egypt.
5
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
6
GLIDE Technical Cooperation and Research, Ribeirão Preto, São Paulo, Brazil.
7
Department of Paediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
8
Social Department of Ribeirão Preto, Medical School, University of São Paulo, São Paulo, Brazil.
9
King Edward Memorial Hospital for Women, Subiaco, WA, Australia.

Abstract

BACKGROUND:

What constitutes respectful maternity care (RMC) operationally in research and programme implementation is often variable.

OBJECTIVES:

To develop a conceptualisation of RMC.

SEARCH STRATEGY:

Key databases, including PubMed, CINAHL, EMBASE, Global Health Library, grey literature, and reference lists of relevant studies.

SELECTION CRITERIA:

Primary qualitative studies focusing on care occurring during labour, childbirth, and/or immediately postpartum in health facilities, without any restrictions on locations or publication date.

DATA COLLECTION AND ANALYSIS:

A combined inductive and deductive approach was used to synthesise the data; the GRADE CERQual approach was used to assess the level of confidence in review findings.

MAIN RESULTS:

Sixty-seven studies from 32 countries met our inclusion criteria. Twelve domains of RMC were synthesised: 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.

CONCLUSIONS:

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 programmes.

TWEETABLE ABSTRACT:

Understanding respectful maternity care - synthesis of evidence from 67 qualitative studies.

KEYWORDS:

Childbirth; dignity; disrespect and abuse; health facility; hesis; qualitative evidence synt; respectful maternity care

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