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Review
. 2022 Jul 7:14:847-879.
doi: 10.2147/IJWH.S341907. eCollection 2022.

Respectful Maternity Care in South Asia: What Does the Evidence Say? Experiences of Care and Neglect, Associated Vulnerabilities and Social Complexities

Sabitra Kaphle  1 , Geraldine Vaughan  2 , Madhusudan Subedi  3
Affiliations
Review

Respectful Maternity Care in South Asia: What Does the Evidence Say? Experiences of Care and Neglect, Associated Vulnerabilities and Social Complexities

Sabitra Kaphle et al. Int J Womens Health. .

Abstract

Background: Respectful maternity care encompasses the right to continuity of care and dignified support for women during the reproductive period, enabling informed choice. However, the evidence is limited in the context of South Asia region where maternal, perinatal and newborn mortality is still a critical challenge to health systems. Evidence is required to better understand the context of respectful maternity care to inform directions for appropriate policy and practice.

Objective: The objective of this scoping review was to explore facilitators and barriers of respectful maternity care practice in South Asia.

Design: CINAHL, EMBASE, PubMed, Medline, SCOPUS and Cochrane databases were used to identify related studies. Data were systematically synthesized and analysed thematically.

Findings: There was considerable heterogeneity in the 61 included studies from seven South Asian countries, with most of the research conducted in Nepal and India. While the experience of abuse and neglect was common, 10 critical themes emerged related to neglected choices and compromised quality of care (particularly where there were health inequities) in the context of institutional care experiences; and the imperative for improved investment in training and significant policy and legislative change to enforce equitable and respectful maternity care practice.

Conclusions and implications for practice: Evidence about respectful maternity care in South Asia indicates that women accessing professional and facility-based services experienced high levels of disrespect, abuse and maltreatment. Women from vulnerable, socially disadvantaged and economically poor backgrounds were more likely to experience higher level abuse and receive poor quality of care. There is an urgent need for a well-resourced, sustained commitment to mandate and support the provision of respectful and equitable maternity care practice in South Asia.

Keywords: South Asia; health service; maternal health; maternity care; pregnancy; respect.

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Conflict of interest statement

The authors report no conflicts of interest in relation to this work.

Figures

Figure 1
Figure 1
PRISMA reporting framework for study selection.
Figure 2
Figure 2
A map of included studies in the review by country.
Figure 3
Figure 3
A diagram of reported themes from the scoping review.
See this image and copyright information in PMC

References

    1. Howell EA. Reducing disparities in severe maternal morbidity and mortality. Clin Obstet Gynecol. 2018;61(2):387–399. doi:10.1097/GRF.0000000000000349 - DOI - PMC - PubMed
    1. Miller S, Abalos E, Chamillard M, et al. Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. Lancet. 2016;388(10056):2176–2192. doi:10.1016/S0140-6736(16)31472-6 - DOI - PubMed
    1. Kaphle S, Hancock H, Newman LA. Childbirth traditions and cultural perceptions of safety in Nepal: critical spaces to ensure the survival of mothers and newborns in remote mountain villages. Midwifery. 2013;29(10):1173–1181. doi:10.1016/j.midw.2013.06.002 - DOI - PubMed
    1. Kaphle S, Newman L. Critical social determinants of childbirth outcomes in remote mountains: voices of women from Nepal. J Asian Midwives. 2020;7(2):16–32.
    1. Afulani PA, Moyer CA. Accountability for respectful maternity care. Lancet. 2019;394(10210):1692–1693. doi:10.1016/S0140-6736(19)32258-5 - DOI - PubMed

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