Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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

E Shakibazadeh  1 , M Namadian  2 , M A Bohren  3 , J P Vogel  3 , A Rashidian  4   5 , V Nogueira Pileggi  6   7 , S Madeira  8 , S Leathersich  9 , Ӧ Tunçalp  3 , O T Oladapo  3 , J P Souza  3 , A M Gülmezoglu  3
Affiliations

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

E Shakibazadeh et al. BJOG. 2018 Jul.

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Detailed study‐selection process.
Figure 2
Figure 2
Geographical distribution of the contributing primary research countries in the analysis synthesis.
See this image and copyright information in PMC

Comment in

References

    1. WHO . The global strategy for women's, children's and adolescents’ health (2016‐2030). 2015. [http://www.who.int/life-course/partners/global-strategy/en]. Accessed 17 July 2017.
    1. WHO, UNICEF, UNFPA, World Bank Group, The United Nations Population Division . Trends in maternal mortality: 1990 to 2015; Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2015 [http://www.who.int/reproductivehealth/publications/monitoring/maternal-m...]. Accessed 10 June 2017.
    1. Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario‐based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter‐Agency Group. Lancet 2016;387:462–74. - PMC - PubMed
    1. Bohren MA, Hunter EC, Munthe‐Kaas HM, Souza JP, Vogel JP, Gulmezoglu AM. Facilitators and barriers to facility‐based delivery in low‐ and middle‐income countries: a qualitative evidence synthesis. Reprod Health 2014;11:71. - PMC - PubMed
    1. Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The mistreatment of women during childbirth in health facilities globally: a mixed‐methods systematic review. PLoS Med 2015;12:e1001847. - PMC - PubMed

Publication types