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. 2025 Mar 13;22(1):40.
doi: 10.1186/s12978-025-01969-4.

Promoting respectful maternity care: a quasi-experimental study on the effectiveness of an educational intervention in Iranian hospitals

Maryam Tajvar  1 , Shohreh Alipour  2 , Omolbanin Atashbahar  3 , Elham Shakibazadeh  4 , Abdul Sami Saeed  2 , Zeinab Khaledian  5   6
Affiliations

Promoting respectful maternity care: a quasi-experimental study on the effectiveness of an educational intervention in Iranian hospitals

Maryam Tajvar et al. Reprod Health. .

Abstract

Background: Respectful Maternal Care (RMC) is a crucial strategy for improving the quality of maternity care and reducing mortality and morbidity among mothers. This study aimed to evaluate the effect of an RMC educational intervention on reducing mistreatment during maternal care.

Methods: A quasi-experimental study was conducted in two intervention hospitals and two control hospitals affiliated with Tehran University of Medical Sciences. Initially, the provision of RMC in all four hospitals was assessed through an RMC questionnaire completed by newly delivered mothers (n = 357) in a cross-sectional study. Subsequently, an educational intervention was designed and implemented from September to November 2020 exclusively in the two intervention hospitals, targeting midwives working in the delivery department. Approximately four months post-intervention, in June 2021, the status of RMC was evaluated in all hospitals through a cross-sectional survey of 383 newly delivered women. The differences in RMC scores between pre- and post-intervention between the two groups of hospitals were assessed. The Generalized Estimating Equations (GEE) model was used to analyze the effectiveness of the educational intervention in practicing RMC while controlling for background variables.

Results: Mothers who received delivery services at certain hospitals, had lower levels of education, or were younger were more likely to experience disrespectful maternal care during labor and delivery. During the baseline phase, the intervention and control hospitals exhibited similar rates of mistreatment, with scores of 11.3 and 11.4, respectively. However, four months after implementing the intervention, the incidence of mistreatment in the control hospitals increased by approximately 7 points, while the score in the intervention hospitals decreased by around 10 points. Consequently, the difference between the intervention and control hospitals exceeded 17 points (p < 0.001), which was statistically significant.

Conclusions: The RMC educational intervention significantly reduced mistreatment during childbirth. To fully realize its potential, this intervention should be implemented alongside other strategies by all stakeholders, including providing specialized personnel, motivating staff, and educating mothers about their rights.

Keywords: Childbirth; Educational intervention; Hospital; Iran; Respectful maternity care.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The present study has obtained ethical approval from the Ethics Committee of Tehran University of Medical Science (TUMS) with the reference number IR.TUMS.SPH.REC.1397.015. In all stages of the research, the necessary information about the study and its objectives was provided to the participants, and informed consent was obtained from them before their participation in the study. Furthermore, their data was analyzed confidentially. The authors affirm that all procedures were conducted in compliance with the relevant guidelines and regulations (Declaration of Helsinki). Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The effect of the educational intervention on the reduction of misbehavior before and after the intervention in intervention and control group hospitals
See this image and copyright information in PMC

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